Provider Demographics
NPI:1679671648
Name:FILAK, STEFANI J (MD)
Entity Type:Individual
Prefix:
First Name:STEFANI
Middle Name:J
Last Name:FILAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 MOUNT VERNON AVE
Mailing Address - Street 2:BOX 736
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22301-1328
Mailing Address - Country:US
Mailing Address - Phone:703-671-9799
Mailing Address - Fax:703-671-5660
Practice Address - Street 1:5021 SEMINARY RD STE 109
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1923
Practice Address - Country:US
Practice Address - Phone:703-671-9799
Practice Address - Fax:703-671-5660
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101037599207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA437324OtherANTHEM BC/BS
VAB93866Medicare UPIN
164739Medicare ID - Type Unspecified