Provider Demographics
NPI: | 1053562967 |
---|---|
Name: | VARGA, STEPHEN EARL (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | STEPHEN |
Middle Name: | EARL |
Last Name: | VARGA |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1200 N VEITCH ST |
Mailing Address - Street 2: | APT 1135 |
Mailing Address - City: | ARLINGTON |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 22201-5818 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8260 WILLOW OAKS CORPORATE DR STE 600 |
Practice Address - Street 2: | |
Practice Address - City: | FAIRFAX |
Practice Address - State: | VA |
Practice Address - Zip Code: | 22031-4528 |
Practice Address - Country: | US |
Practice Address - Phone: | 571-472-4670 |
Practice Address - Fax: | 571-665-6798 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2008-10-09 |
Last Update Date: | 2022-12-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | A11662 | 208600000X |
PA | MD459746 | 208600000X |
VA | 0101265513 | 2086S0102X, 208600000X |
390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
No | 2086S0102X | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |