Vivian, Stephan J
Vivian, Stephan J is an individual health care provider with primary practice located at 500 J Clyde Morris Blvd Fl Annex1 , Newport News VA 23601-1929. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Vivian, Stephan J can be contacted via phone (757) 594-2074.Contact Information
Primary practice address
500 J Clyde Morris Blvd Fl Annex1
Newport News VA 23601-1929
Phone: (757) 594-2074
Fax: (757) 594-3369
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 35059262V | Ohio |
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 01081770A | Indiana |
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 0101242715 | Virginia |
Profile Details
NPI number | 1619975877 |
---|---|
LBN Legal business name | Vivian, Stephan J |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 12th, 2005 |
Last updated | Feb 7th, 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1619975877 | NPPES |
Virginia | MEDICAID | 1619975877 | |
Virginia | Other | P00445778 |
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