Provider Demographics
NPI:1609811983
Name:ESTERSON, FAITH DEBRA (MD)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:DEBRA
Last Name:ESTERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:914 MONAGHAN CT
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-1529
Mailing Address - Country:US
Mailing Address - Phone:410-616-9330
Mailing Address - Fax:410-848-6343
Practice Address - Street 1:1838 GREENE TREE RD
Practice Address - Street 2:SUITE 340
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-6391
Practice Address - Country:US
Practice Address - Phone:410-602-3376
Practice Address - Fax:410-602-7954
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD50904207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD070014328Medicare PIN
MDH59618BBMedicare PIN
MDF53351Medicare UPIN