Individual
MARTIN STEVEN STARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
8577 SUDLEY RD, MANASSAS, VA 20110-3860
(703) 368-7166
(703) 368-5103
Mailing address
8577 SUDLEY RD, MANASSAS, VA 20110-3860
(703) 368-7166
(703) 368-5103
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000264
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0442570002
DMERC
—
01
—
090273
ANTHEM BCBS
—
01
—
32614
UNITED HEALTH CARE MAMSI
—
01
—
4085685
AETNA
—
05
—
9331492
—
VA
01
—
A8890001
CAREFIRST BCBS
—
Enumeration date
02/06/2006
Last updated
07/08/2007
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