Provider Demographics
NPI:1538186176
Name:STONE, THERESA A (MD)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:A
Last Name:STONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 19TH ST NW
Mailing Address - Street 2:SUITE 700
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3701
Mailing Address - Country:US
Mailing Address - Phone:202-223-5333
Mailing Address - Fax:202-223-5337
Practice Address - Street 1:1145 19TH ST NW
Practice Address - Street 2:SUITE 700
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3701
Practice Address - Country:US
Practice Address - Phone:202-223-5333
Practice Address - Fax:202-223-5337
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD31162207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCMD31162OtherMEDICAL LICENSE
DCCS9910899OtherCONTROLLED SUBSTANCE LICE
DCCS9910899OtherCONTROLLED SUBSTANCE LICE
DCG36246Medicare UPIN