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Individual

DR. SHAUNA STUPART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
9501 FARRELL ROAD, FORT BELVOIR, VA 22060
(703) 805-0642
Mailing address
PO BOX 1439, OLNEY, MD 20830-1439
(202) 483-8196

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101239167
VA
207Q00000X
Family Medicine Physician
A81014
CA

Other

Enumeration date
06/22/2006
Last updated
07/21/2022
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