Individual
HEATHER STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20306 BADGER LANE, ONLEY, VA 23418
(757) 787-7374
(757) 787-4513
Mailing address
20306 BADGER LANE, ONLEY, VA 23418
(757) 787-7374
(757) 787-4513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101050794
VA
Other
Enumeration date
01/06/2006
Last updated
08/28/2012
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