1942272307 NPI number — ROBERT BRIAN STEPHENSON MD

Table of content: ROBERT BRIAN STEPHENSON MD (NPI 1942272307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942272307 NPI number — ROBERT BRIAN STEPHENSON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEPHENSON
Provider First Name:
ROBERT
Provider Middle Name:
BRIAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942272307
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/09/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2900 LAMB CIRCLE
Provider Second Line Business Mailing Address:
SUITE L-760
Provider Business Mailing Address City Name:
CHRISTIANSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24073-6345
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-731-2436
Provider Business Mailing Address Fax Number:
540-731-2439

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 LAMB CIR
Provider Second Line Business Practice Location Address:
SUITE L-760
Provider Business Practice Location Address City Name:
CHRISTIANSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24073-6344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-731-2436
Provider Business Practice Location Address Fax Number:
540-731-2439
Provider Enumeration Date:
02/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207XX0005X , with the licence number:  0101042429 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1942272307 . This is a "INTOTAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "OWCP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "GATEWAY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541586601118 . This is a "TRICARE/CHAMPUS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 3810002168 . This is a "MEDICAID OF WEST VIRGINIA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "OPTIMA HEALTH PLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "HEALTHKEEPERS PLUS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "VA HEALTH NETWORK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1942272307 . This is a "HUMANA MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "UMWA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "VA PREMIER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "SOUTHERN HEALTH/CARENET/CARELINK/COVENTRY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "HEALTHKEEPERS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942272307 . This is a "MAJESTACARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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