Provider Demographics
NPI:1851397467
Name:DAY, STEPHEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:DAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 TELESTAR CT.
Mailing Address - Street 2:#300
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1261
Mailing Address - Country:US
Mailing Address - Phone:703-591-1688
Mailing Address - Fax:703-591-1445
Practice Address - Street 1:4825 MARK CENTER DR STE 150
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1846
Practice Address - Country:US
Practice Address - Phone:703-751-8111
Practice Address - Fax:703-751-1105
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057025207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1851397467Medicaid
DC029735400Medicaid
MD101700400Medicaid
DC060059673OtherRAILROAD MEDICARE DC#
VA060059673OtherRAILROAD MEDICARE VA#
DC005079C42Medicare PIN
VA020285T55Medicare PIN
DC060059673OtherRAILROAD MEDICARE DC#
VA005868416Medicaid
VA5838746Medicaid