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NPI 1831815679

NPI 1831815679 : STEFAN INOUYE : FORT BELVOIR, VA

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General NPI Number Information
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    NPI Number           |    1831815679
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    Entity Type          |    Individual 
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    Provider Name        |    STEFAN INOUYE
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/13/2022
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    Last Update Date     |    09/02/2025
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Provider Practice Location Address
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    Address Line         |    9300 DEWITT LOOP 
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    City                 |    FORT BELVOIR
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    State                |    VA
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    Zip                  |    22060-5285
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    Country              |    US
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    Telephone            |    571-231-2198
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9300 DEWITT LOOP 
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    City                 |    FORT BELVOIR
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    State                |    VA
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    Zip                  |    22060-5285
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    Country              |    US
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    Telephone            |    
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PTL.0018664
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    License Number State |    CO
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