MEDICARE: STEPHEN VAN DAVIS 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	207RC0000X	Cardiovascular Disease Physician	MD-25962	HI
2	207RC0000X	Cardiovascular Disease Physician	0101038033	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124026588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN VAN DAVIS MD

Provider Business Mailing Address
First Line	:	200 DEER RUN RD
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24540-2866
Country	:	US
Telephone Number	:	434-799-0090
Fax Number	:	434-799-0098

Provider Business Practice Location Address
First Line	:	200 DEER RUN RD
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24540-2866
Country	:	US
Telephone Number	:	434-799-0090
Fax Number	:	434-799-0098

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	08/15/2025

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Directions to “ STEPHEN VAN DAVIS MD” Practice Location

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