Provider Demographics
NPI:1255318069
Name:POWERS, STEVEN BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:BRIAN
Last Name:POWERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 KINGSBOROUGH SQUARE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5054
Mailing Address - Country:US
Mailing Address - Phone:757-436-0167
Mailing Address - Fax:757-436-0236
Practice Address - Street 1:612 KINGSBOROUGH SQ
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5041
Practice Address - Country:US
Practice Address - Phone:757-436-0167
Practice Address - Fax:757-436-0236
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041169207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA285756OtherANTHEM BC/BS
VA6204805Medicaid
VAE69187Medicare UPIN
VA160001667Medicare PIN