Provider Demographics
NPI:1164683009
Name:REPOLE, STEPHANIE K (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:K
Last Name:REPOLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:R
Other - Last Name:KRUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:155 KINGSLEY LN STE 405
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-4629
Mailing Address - Country:US
Mailing Address - Phone:757-278-2220
Mailing Address - Fax:757-489-0701
Practice Address - Street 1:844 BATTLEFIELD BLVD N STE 100
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4802
Practice Address - Country:US
Practice Address - Phone:757-312-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101248355208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery