Healthcare Provider Details

I. General information

NPI: 1881771483
Provider Name (Legal Business Name): STEPHANIE B. TROY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 FAIRFAX AVE SUITE 545
NORFOLK VA
23507-1914
US

IV. Provider business mailing address

PO BOX 936
NORFOLK VA
23501-0936
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-8999
  • Fax: 757-446-7922
Mailing address:
  • Phone: 757-446-8999
  • Fax: 757-446-7922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number0101249323
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: