Provider Demographics
NPI:1639663883
Name:ESTEPA, ADRIAN TABUENA (MD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:TABUENA
Last Name:ESTEPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 OLD LANCASTER RD STE 320
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3235
Mailing Address - Country:US
Mailing Address - Phone:610-527-3800
Mailing Address - Fax:
Practice Address - Street 1:825 OLD LANCASTER RD STE 350
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3238
Practice Address - Country:US
Practice Address - Phone:610-527-8118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT216723207R00000X
PAMD474991207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine