Provider Demographics
NPI:1184725962
Name:MEYERS, STUART A (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:A
Last Name:MEYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1502 FEATHERSTONE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3100
Mailing Address - Country:US
Mailing Address - Phone:703-491-6877
Mailing Address - Fax:757-456-0645
Practice Address - Street 1:1502 FEATHERSTONE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3100
Practice Address - Country:US
Practice Address - Phone:703-491-6877
Practice Address - Fax:757-456-0645
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA06L10088207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5802016Medicaid
VA5802016Medicaid
VAC88157Medicare UPIN
DC169955S53Medicare PIN