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General NPI Number Information
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NPI Number | 1447489174
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Entity Type | Individual
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Provider Name | STEPHANIE B NG D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 2201 CHARLES ST STE 103
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3378
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Country | US
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Telephone | 703-585-8285
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Fax |
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Provider Business Mailing Address
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Address Line | 7214 TANAGER ST
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City | SPRINGFIELD
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State | VA
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Zip | 22150-3533
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Country | US
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Telephone | 973-828-5731
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | H0082340
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | DO034787
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0102204276
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License Number State | VA
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