Healthcare Provider Details

I. General information

NPI: 1306306394
Provider Name (Legal Business Name): STEPHANIE GRACE-SCHELL KLIMES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. STEPHANIE GRACE SCHELL

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 FAIRFAX AVE STE 544
NORFOLK VA
23507-1914
US

IV. Provider business mailing address

825 FAIRFAX AVE STE 544
NORFOLK VA
23507-1914
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-7900
  • Fax:
Mailing address:
  • Phone: 757-446-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101270496
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: