Individual
DR. STEPHEN G. HARRISON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1830 TOWN CENTER DR, SUITE # 205, RESTON, VA 20190-3292
(703) 435-3636
(703) 435-9145
Mailing address
10691 ALLIWELLS CT, OAKTON, VA 22124-1771
(703) 435-3636
(703) 435-9145
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101028882
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6709559
—
VA
Enumeration date
03/31/2006
Last updated
07/08/2007
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