Healthcare Provider Details

I. General information

NPI: 1881854982
Provider Name (Legal Business Name): JOHN PAUL STEG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6760 OLD MCLEAN VILLAGE DR
MC LEAN VA
22101-3906
US

IV. Provider business mailing address

1837 BALDWIN DR
MC LEAN VA
22101-5055
US

V. Phone/Fax

Practice location:
  • Phone: 703-442-8116
  • Fax: 703-442-8116
Mailing address:
  • Phone: 703-442-8116
  • Fax: 703-442-8116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0101024182
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: