Provider Demographics
NPI:1295020980
Name:DONALD J STEFL, DPM
Entity Type:Organization
Organization Name:DONALD J STEFL, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEFL
Authorized Official - Suffix:II
Authorized Official - Credentials:DPM
Authorized Official - Phone:540-774-5585
Mailing Address - Street 1:2705 BRAMBLETON AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-4307
Mailing Address - Country:US
Mailing Address - Phone:540-774-5585
Mailing Address - Fax:540-774-5703
Practice Address - Street 1:2705 BRAMBLETON AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24015-4307
Practice Address - Country:US
Practice Address - Phone:540-774-5585
Practice Address - Fax:540-774-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA480000047OtherPTAN
VA9301836Medicaid
VA480000047OtherPTAN