Provider Demographics
NPI:1972592947
Name:MURZA, STEFAN (DC)
Entity type:Individual
Prefix:DR
First Name:STEFAN
Middle Name:
Last Name:MURZA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3032 TYRE NECK RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-4527
Mailing Address - Country:US
Mailing Address - Phone:757-484-7000
Mailing Address - Fax:757-484-7676
Practice Address - Street 1:3032 TYRE NECK RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-4527
Practice Address - Country:US
Practice Address - Phone:757-484-7000
Practice Address - Fax:757-484-7676
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2022-12-05
Deactivation Date:2017-12-19
Deactivation Code:
Reactivation Date:2022-12-05
Provider Licenses
StateLicense IDTaxonomies
NC1988111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350001172Medicare PIN
VAU40459Medicare UPIN