Individual
LISA PRICE STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
549 E BRAMBLETON AVE, NORFOLK, VA 23510-2905
(757) 533-9441
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
(757) 533-9441
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101054288
VA
207R00000X
Internal Medicine Physician
257466
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005883652
—
VA
05
—
1124097621
—
VA
01
—
462588
ANTHEM
VA
01
—
541595397
CIGNA
VA
01
—
5611631
AETNA
VA
01
—
62742
SENTARA/OPTIMA
VA
Enumeration date
02/23/2006
Last updated
03/19/2020
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