Heather Stark, MD

Individual provider Active NPI Family Medicine Physician · Onley, VA

NPI 1003894262 · NPPES record last updated Aug 28, 2012

Key facts

NPI
1003894262
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
0101050794 (VA)
Practice address
20306 Badger Lane
Onley, VA 23418
Phone
(757) 787-7374
Fax
(757) 787-4513
NPI assigned
Jan 6, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101050794 VA Yes

Addresses

Primary practice location

20306 Badger Lane
Onley, VA 23418

Mailing address

20306 Badger Lane
Onley, VA 23418
Phone (757) 787-7374

Other providers in Onley, VA

All providers in Onley, VA · Family Medicine Physician in Virginia

Sources for this page

Verify at the official NPI Registry.