Basic Information
Provider Information
NPI: 1780658591
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIGGS
FirstName: STEPHEN
MiddleName: ALEXANDER
NamePrefix:  
NameSuffix:  
Credential: MPAS, PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5000 COX RD
Address2:  
City: GLEN ALLEN
State: VA
PostalCode: 230609263
CountryCode: US
TelephoneNumber: 8049685700
FaxNumber:  
Practice Location
Address1: 2425 TAYLOR RD
Address2:  
City: CHESAPEAKE
State: VA
PostalCode: 233212201
CountryCode: US
TelephoneNumber: 7572151800
FaxNumber: 7572151821
Other Information
ProviderEnumerationDate: 02/16/2006
LastUpdateDate: 02/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X0110002264VAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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