Healthcare Provider Details

I. General information

NPI: 1689653727
Provider Name (Legal Business Name): BARBARA A STEVENS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 06/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3833 FAIRFAX DR 201
ARLINGTON VA
22203-1701
US

IV. Provider business mailing address

3833 FAIRFAX DR SUITE 201
ARLINGTON VA
22203-1772
US

V. Phone/Fax

Practice location:
  • Phone: 703-351-9424
  • Fax:
Mailing address:
  • Phone: 703-351-9424
  • Fax: 703-351-9429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101239094
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: