Healthcare Provider Details

I. General information

NPI: 1053562967
Provider Name (Legal Business Name): STEPHEN EARL VARGA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 WILLOW OAKS CORPORATE DR STE 600
FAIRFAX VA
22031-4528
US

IV. Provider business mailing address

1200 N VEITCH ST APT 1135
ARLINGTON VA
22201-5818
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-4670
  • Fax: 571-665-6798
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA11662
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD459746
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number0101265513
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101265513
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: