Healthcare Provider Details

I. General information

NPI: 1437266129
Provider Name (Legal Business Name): STEVEN SCOTT WARDEN MD FACS MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 1ST COLONIAL RD SUITE 101
VIRGINIA BEACH VA
23454
US

IV. Provider business mailing address

1004 1ST COLONIAL RD SUITE 101
VIRGINIA BEACH VA
23454
US

V. Phone/Fax

Practice location:
  • Phone: 757-481-9402
  • Fax: 757-481-0657
Mailing address:
  • Phone: 757-481-9402
  • Fax: 757-481-0657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0101031498
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: