Stevens, Mark T
Stevens, Mark T is an individual health care provider with primary practice located at 10706 Wynkoop Dr , Great Falls VA 22066-1606. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Stevens, Mark T can be contacted via phone (703) 282-9468.Contact Information
Primary practice address
10706 Wynkoop Dr
Great Falls VA 22066-1606
Phone: (703) 282-9468
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | 0101257868 | Virginia |
Profile Details
| NPI number | 1760499669 |
|---|---|
| LBN Legal business name | Stevens, Mark T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2006 |
| Last updated | Dec 17th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760499669 | NPPES |
| Nebraska | Other | 23419 | STATE LICENSE |
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