Provider Demographics
NPI:1881771483
Name:TROY, STEPHANIE B
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:B
Last Name:TROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-8999
Mailing Address - Fax:757-446-7922
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 545
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-8999
Practice Address - Fax:757-446-7922
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249323207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9385341OtherAETNA
VAPAROtherCORVEL
VA-032OtherTRICARE/CHAMPUS
NC5917369Medicaid
VAPAROtherUSA MANAGED CARE
VA10076822OtherOPTIMA HEALTH
VAPAROtherVIRGINIA PREMIER HEALTH PLAN
VA1881771483Medicaid
VA427632OtherANTHEM BC/BS
VAPAROtherUNITED HEALTHCARE/MAMSI
VAPAROtherCIGNA
VAPAROtherVIRGINIA HEALTH NETWORK
VA1881771483OtherFIRST HEALTH NETWORK/COVENTRY HEALTH
VAPAROtherMULTIPLAN
VA1881771483OtherFIRST HEALTH NETWORK/COVENTRY HEALTH
VAPAROtherCORVEL