Individual
KEITH R STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 LAMB CIR, SUITE 300, CHRISTIANSBURG, VA 24073-6344
(540) 639-5900
(540) 639-0976
Mailing address
301 CRAIG DR, BLACKSBURG, VA 24060-1830
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101-233788
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007313411
—
VA
05
—
007313420
—
VA
05
—
007313560
—
VA
05
—
010269024
—
VA
Enumeration date
11/10/2005
Last updated
08/12/2011
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