Provider Demographics
NPI:1588646921
Name:SOLOMON, STEPHEN G (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:G
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3998 FAIR RDIGE DRIVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033
Mailing Address - Country:US
Mailing Address - Phone:703-295-9360
Mailing Address - Fax:703-295-9369
Practice Address - Street 1:226 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-0810
Practice Address - Country:US
Practice Address - Phone:845-343-6216
Practice Address - Fax:845-343-6228
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2015-03-24
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Provider Licenses
StateLicense IDTaxonomies
NY167022207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01127137Medicaid
D92031Medicare UPIN
NY01127137Medicaid