Provider Demographics
NPI:1659345072
Name:DAVIS, STEPHEN SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:SCOTT
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:EVMS MEDICAL GROUP
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-7979
Mailing Address - Fax:757-624-2254
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-7979
Practice Address - Fax:757-624-2254
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2013-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101237694207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA280074OtherANTHEM 601 COLLEY AVE
NC00291OtherBC/BS
VA174985OtherANTHEM
NC5900291Medicaid
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherUSA MANAGED CARE
VA-010OtherTRICARE/CHAMPUS
VA010139741Medicaid
VA185091OtherANTHEM
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherCIGNA
VAPAROtherAETNA
VA93557OtherSENTARA OPTIMA
VAPAROtherMULTIPLAN
VA3115775OtherUHC/MAMSI
VAPAROtherCORVEL/CORCARE
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHEN HEALTH/COVENTRY
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherVIRGINIA HEALTH NETWORK
VA185091OtherANTHEM