Provider Demographics
NPI:1639114887
Name:STIBAL, DARLENE M (MD)
Entity type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:M
Last Name:STIBAL
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 1:287 PINE REACH DR
Mailing Address - Street 2:
Mailing Address - City:KILMARNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22482-3721
Mailing Address - Country:US
Mailing Address - Phone:704-701-7781
Mailing Address - Fax:
Practice Address - Street 1:95 HARRIS RD
Practice Address - Street 2:
Practice Address - City:KILMARNOCK
Practice Address - State:VA
Practice Address - Zip Code:22482-3845
Practice Address - Country:US
Practice Address - Phone:804-435-1609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039978208600000X
NC32583208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC80035OtherBCBSNC
NC8980035Medicaid
NC80035OtherBCBSNC
NC8980035Medicaid
C82345Medicare UPIN