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NPI Code Detail

MEDICARE: ERIKA JANE STEPHAN P.T.

MEDICARE: ERIKA JANE STEPHAN P.T.
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
1225100000XPhysical Therapist2305003712VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13411029OTHERVAAETNA PROVIDER#
2200143785OTHERVATAX ID#
3444255OTHERVAMAMSI PROVIDER#
4463830OTHERVAANTHEM BCBS ID#
549827OTHERVAOPTIMA PROVIDER#

General Provider Information

NPI Number : 1629080312
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIKA JANE STEPHAN P.T.
Provider Business Mailing Address
First Line : 5388 DISCOVERY PARK BLVD
Second Line : SUITE 200
City : WILLIAMSBURG
State : VA
Zip : 23188-8218
Country : US
Telephone Number : 757-707-3955
Fax Number : 757-603-6231
Provider Business Practice Location Address
First Line : 201 BULIFANTS BLVD STE B
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23188-5731
Country : US
Telephone Number : 757-229-9740
Fax Number : 757-229-9741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 04/20/2023

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Directions to “ ERIKA JANE STEPHAN P.T.” Practice Location

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