Provider Demographics
NPI:1902465750
Name:TEACHOUT, STEPHANIE (MBBS)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:TEACHOUT
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW STE 2A-68
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-7445
Mailing Address - Fax:202-877-9966
Practice Address - Street 1:110 IRVING ST NW STE 2-68
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-7445
Practice Address - Fax:202-877-9966
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program