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Individual
SAMUEL FISK DESTEFANO
Active
Individual
SAMUEL FISK DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
Primary
CDRH.0058144
CO
2084E0001X
Epilepsy Physician
DR.0058144
CO
2084N0400X
Neurology Physician
0058144
CO
2084N0400X
Neurology Physician
036-176812
IL
2084N0600X
Clinical Neurophysiology Physician
DR.0058144
CO
Other
Enumeration date
04/03/2013
Last updated
12/03/2025
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