Provider Demographics
NPI:1073699021
Name:INTERNISTS OF CHURCHLAND, LTD
Entity Type:Organization
Organization Name:INTERNISTS OF CHURCHLAND, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-484-5828
Mailing Address - Street 1:4041 TAYLOR RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5525
Mailing Address - Country:US
Mailing Address - Phone:757-484-5828
Mailing Address - Fax:757-484-4371
Practice Address - Street 1:4041 TAYLOR RD
Practice Address - Street 2:SUITE G
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5525
Practice Address - Country:US
Practice Address - Phone:757-484-5828
Practice Address - Fax:757-484-4371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty