Healthcare Provider Details

I. General information

NPI: 1457598880
Provider Name (Legal Business Name): STEPHEN ANTHONY SMITH DSC, PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US

IV. Provider business mailing address

7700 ARLINGTON BLVD STE 5101
FALLS CHURCH VA
22042-5101
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-2556
  • Fax:
Mailing address:
  • Phone: 703-681-5647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberNCCPA - 1100953
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: