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Individual

ANDREA A. STUTESMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3300 RIVERMONT AVE, LYNCHBURG, VA 24503-2030
(434) 200-4651
Mailing address
1204 FENWICK DR, LYNCHBURG, VA 24502-2112
(434) 200-3656

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101238772
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
203639329004
TRICARE
01
354830
ANTHEM
Enumeration date
05/05/2008
Last updated
02/05/2009
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