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General NPI Number Information
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NPI Number | 1265693410
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Entity Type | Individual
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Provider Name | STACY N. HOM MD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 11/22/2025
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Provider Practice Location Address
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Address Line | 4853 CORDELL AVE PH 10
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City | BETHESDA
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State | MD
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Zip | 20814-3036
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Country | US
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Telephone | 240-262-3194
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Fax | 240-655-0648
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Provider Business Mailing Address
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Address Line | 4853 CORDELL AVE PH 10
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City | BETHESDA
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State | MD
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Zip | 20814-3036
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Country | US
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Telephone | 240-262-3194
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Fax | 240-655-0648
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0102201
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License Number State | MD
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