Individual
JACK A STABILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 689-3138
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 882-0705
(919) 873-9821
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101049205
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0061802000
—
WV
05
—
1003843434
—
VA
05
—
149801100
—
MD
Enumeration date
06/28/2006
Last updated
05/20/2014
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