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RANDOLPH W. STARK, M.D., PA
NPI 1639354244
Specialist in Manassas, VA

Active since January 02, 2008
10680 CRESTWOOD DR STE B, MANASSAS, VA 20109(703) 361-6054(703) 330-9095 Get Directions Write a Review

NPPES record last updated: October 20, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Randolph W. Stark, M.d., Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDOLPH W. STARK, M.D., PA (NPI 1639354244) is a healthcare organization registered as a specialist in Manassas, Virginia and active in the NPI registry since January 2008. The organization lists Norma J Heinrich, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1639354244
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameRANDOLPH W. STARK, M.D., PA
Location Address10680 CRESTWOOD DR STE BManassas, VA 20109-4402
Mailing Address10680 Crestwood Dr Ste BManassas, VA 20109-4402 · (703) 361-6054 · Fax (703) 330-9095
Phone(703) 361-6054
Fax(703) 330-9095
Organization SubpartNo
Authorized OfficialNorma J HeinrichOffice Manager · (877) 257-9619
Enumeration DateJanuary 2, 2008
Last NPPES UpdateOctober 20, 2009
✔ NPI 1639354244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in VA · 0101036334
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.
10680 CRESTWOOD DR STE B, Manassas, VA 20109
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Other Identifiers 2

Medicare UPINB06147VA
Medicare PINGC1182VA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randolph W. Stark, M.D., PA's NPI number?

The NPI number for Randolph W. Stark, M.D., PA is 1639354244. It was assigned to this organization in the NPPES registry on January 2, 2008.

Where is Randolph W. Stark, M.D., PA located?

Randolph W. Stark, M.D., PA is located at 10680 Crestwood Dr Ste B, Manassas, VA 20109. The listed phone number is (703) 361-6054.

What is Randolph W. Stark, M.D., PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Randolph W. Stark, M.D., PA was last updated on October 20, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.