Healthcare Provider Details

I. General information

NPI: 1740302835
Provider Name (Legal Business Name): HARVARD WILLIAM STEPHENS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 ATMORE DR
RICHMOND VA
23225-5644
US

IV. Provider business mailing address

713 BOULDER SPRINGS DR APT B4
RICHMOND VA
23225-5532
US

V. Phone/Fax

Practice location:
  • Phone: 804-674-3578
  • Fax:
Mailing address:
  • Phone: 615-294-4913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number01011236261
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: