Provider Demographics
NPI:1437562592
Name:STAHR, SAMANTHA T (OD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:T
Last Name:STAHR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:L
Other - Last Name:TRIPLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2016 MEADE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434
Mailing Address - Country:US
Mailing Address - Phone:757-539-1533
Mailing Address - Fax:757-539-6591
Practice Address - Street 1:2016 MEADE PKWY
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4259
Practice Address - Country:US
Practice Address - Phone:757-539-1533
Practice Address - Fax:757-543-9659
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002319152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist