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General NPI Number Information
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NPI Number | 1659379105
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Entity Type | Organization
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Legal Business Name | GRACE J. STONEROCK, MD, PC
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 10696 CRESTWOOD DR
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City | MANASSAS
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State | VA
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Zip | 20109-4411
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Country | US
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Telephone | 703-368-7110
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Fax | 703-369-1842
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Provider Business Mailing Address
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Address Line | 10696 CRESTWOOD DR
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City | MANASSAS
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State | VA
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Zip | 20109-4411
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Country | US
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Telephone | 703-368-7110
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Fax | 703-369-1842
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Authorized Official
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Title or Position | PRESIDENT/M.D.
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Name | MRS. GRACE J STONEROCK
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Credential | M.D.
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Telephone | 703-368-7110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101045665
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License Number State | VA
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