Provider Demographics
NPI:1922213016
Name:STAGG, AHMAD RASHAD (DPT)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:RASHAD
Last Name:STAGG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5937 CLEARSPRING CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4901
Mailing Address - Country:US
Mailing Address - Phone:757-450-4627
Mailing Address - Fax:
Practice Address - Street 1:5937 CLEARSPRING CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4901
Practice Address - Country:US
Practice Address - Phone:757-450-4627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204333225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist