Provider Demographics
NPI:1184725806
Name:STEWART, VIRGINIA ANNETTE (MD)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:ANNETTE
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:230 GEORGE ST
Mailing Address - Street 2:STE 2
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2620
Mailing Address - Country:US
Mailing Address - Phone:757-889-6500
Mailing Address - Fax:757-889-6505
Practice Address - Street 1:160 KINGSLEY LN
Practice Address - Street 2:SUITE 400
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4600
Practice Address - Country:US
Practice Address - Phone:757-889-6500
Practice Address - Fax:757-889-6505
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2024-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEMD28702208600000X
WV27356208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010383536Medicaid
VA298483OtherANTHEM
VA10223419OtherOPTIMA
VA5666154OtherCIGNA
VA10223419OtherOPTIMA