Stephenson, Randolph R

Stephenson, Randolph R is an individual health care provider with primary practice located at 3020 Hamaker Ct Suite 400, Fairfax VA 22031-2238. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Brain Injury Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Stephenson, Randolph R can be contacted via phone (703) 876-0800.

Contact Information

Primary practice address
3020 Hamaker Ct Suite 400 Fairfax VA 22031-2238
Phone: (703) 876-0800
Fax: (703) 876-0866
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Brain Injury Medicine 2084P0301X 0101245264 Virginia
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 0101245264 Virginia

Profile Details

NPI number 1538352430
LBN Legal business name Stephenson, Randolph R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2007
Last updated Jun 8th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538352430 NPPES
Virginia MEDICAID 1538352430

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