Provider Demographics
NPI:1003864372
Name:STARK, JAMES J (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:STARK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5835 HARBOUR VIEW BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2657
Mailing Address - Country:US
Mailing Address - Phone:757-397-4200
Mailing Address - Fax:757-397-3872
Practice Address - Street 1:5835 HARBOUR VIEW BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2657
Practice Address - Country:US
Practice Address - Phone:757-397-4200
Practice Address - Fax:757-397-3872
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101028190207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3536407004OtherCIGNA
VA656352OtherMAMSI (INTERNAL)
VA208484OtherANTHEM BCBS
NC8906547OtherNORTH CAROLINA MEDICAID
VA4004872OtherAETNA
VA956352OtherMAMSI (ONCOLOGY)
VA15878OtherSENTARA/OPTIMA
VA4004872OtherAETNA