Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 0101263805 | VA |
NPI | 1285835488 |
---|---|
Provider Name | Julia Stevenson |
First Address | Chesapeake, VA 23320-4985 |
Second Address | Chesapeake, VA 23320-4985 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 11/08/2020 |