Healthcare Provider Details

I. General information

NPI: 1578645107
Provider Name (Legal Business Name): NEPHROLOGY SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 RIGHT FLANK RD STE 600
MECHANICSVILLE VA
23116-3863
US

IV. Provider business mailing address

7501 RIGHT FLANK RD STE 600
MECHANICSVILLE VA
23116-3863
US

V. Phone/Fax

Practice location:
  • Phone: 804-559-6980
  • Fax: 804-559-6982
Mailing address:
  • Phone: 804-559-6980
  • Fax: 804-559-6982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: TERESA LYNN STEVENS
Title or Position: CREDENTIALING/BILLING ADMINISTRATOR
Credential:
Phone: 804-559-6980