Provider Demographics
NPI:1194978106
Name:STEWART, AMBER J (PA-C)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:J
Last Name:STEWART
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:C
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1270 DIAMOND SPRINGS RD
Mailing Address - Street 2:SUITE 118, #712
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-3729
Mailing Address - Country:US
Mailing Address - Phone:757-562-6673
Mailing Address - Fax:877-503-2599
Practice Address - Street 1:102 FAIRVIEW DR
Practice Address - Street 2:SUITE G
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1226
Practice Address - Country:US
Practice Address - Phone:757-562-6673
Practice Address - Fax:757-562-4344
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104610363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant