Individual
STACEY J ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 VOLVO PKWY, SUITE 200, CHESAPEAKE, VA 23320-1602
(757) 549-4403
(757) 549-4332
Mailing address
5900 LAKE WRIGHT DR, SUITE 300, NORFOLK, VA 23502-1871
(757) 213-5700
(757) 213-5701
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
0101235217
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010090989
—
VA
01
—
75798
OPTIMA
VA
01
—
P00157173
RAILROAD MEDICARE
VA
Enumeration date
06/20/2005
Last updated
09/19/2014
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