Randolph W Stark is a Specialist in Manassas, Virginia. Randolph W Stark practices all healthcare services and medical treatments related to Specialist. The NPI Number for Randolph W Stark is 1164422994. The last update date is 2009-10-20.
Randolph W Stark's current location address is 10680 Crestwood Dr Ste B, Manassas, Virginia. You can contact this provider via phone number 7033616054 and fax number 7033309095. The mailing address for Randolph W Stark is 10680 Crestwood Dr Ste B, Manassas, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randolph W Stark |
|---|---|
| Address | 10680 Crestwood Dr Ste B, Manassas, Virginia |
| Phone Number | 7033616054 |
| Fax Number | 7033309095 |
| Sole Proprietor | N |
| Credentials | M.D. PA |
NPI Number Detail
| NPI Number | 1164422994 |
|---|---|
| Provider Enumeration Date | 2005-07-22 |
| Last Updated Date | 2009-10-20 |
Provider Mailing Address Detail
| Address | 10680 Crestwood Dr Ste B |
|---|---|
| City | Manassas |
| State | Virginia (VA) |
| Post Code | 201094402 |
| Phone Number | 7033616054 |
| Fax Number | 7033309095 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 101036334 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Post Comment/ Review Below
What is the Randolph W Stark's 1164422994?
The Randolph W Stark's NPI (National Provider Identifier) Number is 1164422994. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Randolph W Stark's facilities are geographically located?
The facilities of Randolph W Stark are physically situated at the following location: 10680 Crestwood Dr Ste B, Manassas, VA, 201094402.
What is Randolph W Stark's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Randolph W Stark's specialized field of practice is Specialist, and the corresponding taxonomy code that categorizes this area of specialization is 174400000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1164422994 to Randolph W Stark?
The Centers for Medicare & Medicaid Services originally issued the 1164422994 to Randolph W Stark on 2005-07-22.
As of what date were the details pertaining to Randolph W Stark last refreshed?
The information related to the Randolph W Stark, including its address, specialty, and other relevant details, was last updated on 2009-10-20.
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