Healthcare Provider Details

I. General information

NPI: 1780835348
Provider Name (Legal Business Name): ELFORD M STEPHENS II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 AMHERST ST
WINCHESTER VA
22601-2808
US

IV. Provider business mailing address

P.O. BOX 3297 878 FOX DRIVE
WINCHESTER VA
22604
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-8000
  • Fax: 540-536-7780
Mailing address:
  • Phone: 540-662-8336
  • Fax: 540-662-8593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101251877
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: