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AUDREY E STECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
600 GRESHAM DR, PSMG, NORFOLK, VA 23507-1904
(757) 388-3221
(757) 388-3799
Mailing address
PO BOX 20452, PSMG-CREDENTIALING, COLUMBUS, OH 43220-0452
(614) 442-2406
(614) 442-2410

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101050287
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1376501403
VA
05
89066U7
NC
01
P00111365
RR MEDICARE
VA
Enumeration date
05/01/2006
Last updated
01/22/2014
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