Individual
JOSEPH ANTHONY DESTEFANO JR.
Active
Individual
JOSEPH ANTHONY DESTEFANO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101251249
VA
207R00000X
Internal Medicine Physician
17274
SC
207R00000X
Internal Medicine Physician
Primary
2003-00332
NC
207R00000X
Internal Medicine Physician
38537
TN
208M00000X
Hospitalist Physician
38537
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508841032
—
NC
05
—
1508841032
—
VA
05
—
230214777B
—
GA
05
—
230214777C
—
GA
05
—
3892268
—
TN
05
—
GP3988
—
SC
01
—
NC5448C
MEDICARE PTAN
NC
Enumeration date
12/07/2005
Last updated
04/10/2025
Update your record
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