Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 0101056865 | VA |
N | 207ND0900X | Dermatopathologist | 0101056865 | VA |
N | 207NS0135X | Procedural Dermatology | 0101056865 | VA |
NPI | 1376514596 |
---|---|
Provider Name | Dr. Stephen H Flax |
First Address | Winchester, VA 22601-2803 |
Second Address | Winchester, VA 22601-2803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 26/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000859996 | MTST BCBS (01) | WV |
005901570 | (05) | VA |
234870 | ANTHEM BCBS (01) | VA |
5900003000 | (05) | WV |
G96981 | (02) | VA |