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1063488807

NPI Code Detail

MEDICARE: LISA PRICE STEVENS MD

MEDICARE: LISA PRICE STEVENS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	0101054288	VA
2	207R00000X	Internal Medicine Physician	257466	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	462588	OTHER	VA	ANTHEM
2	541595397	OTHER	VA	CIGNA
3	541595397	OTHER	VA	VIRGINIA HEALTH NETWORK
4	5611631	OTHER	VA	AETNA
5	62742	OTHER	VA	SENTARA/OPTIMA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	541595397	OTHER	VA	TRICARE
9	541595397	OTHER	VA	PRIVATE HEALTHCARE SYSTEM
10	541595397	OTHER	VA	MID ATLANTIC SOLUTIONS

General Provider Information

NPI Number	:	1063488807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA PRICE STEVENS MD

Provider Business Mailing Address
First Line	:	1395 NW 167TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-5710
Country	:	US
Telephone Number	:	757-533-9441
Fax Number	:

Provider Business Practice Location Address
First Line	:	549 E BRAMBLETON AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-2905
Country	:	US
Telephone Number	:	757-533-9441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	03/19/2020

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Directions to “ LISA PRICE STEVENS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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