Basic Information
| Provider Information | |||||||||
| NPI: | 1700990090 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHEAR | ||||||||
| FirstName: | STEPHANYA | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 HEALTH PARK DR FL HP2 | ||||||||
| Address2: | |||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370274525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153737600 | ||||||||
| FaxNumber: | 8777672310 | ||||||||
| Practice Location | |||||||||
| Address1: | 1802 BRAEBURN DR | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | VA | ||||||||
| PostalCode: | 24153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407723702 | ||||||||
| FaxNumber: | 5407723703 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2006 | ||||||||
| LastUpdateDate: | 03/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 0101250086 | VA | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 1700990090 | 01 | VA | HEALTHNET FEDERAL SERVICES | OTHER | 8156940 | 01 | VA | CIGNA | OTHER | 1700990090 | 01 | VA | ANTHEM | OTHER | 1700990090 | 01 | VA | UNITED HEALTHCARE / MAMSI | OTHER | 1700990090 | 01 | VA | GATEWAY HEALTH | OTHER | 1700990090 | 05 | VA | MEDICAID | 5917750 | 05 | NC | MEDICAID |