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NPI Code Detail

MEDICARE: CHARLOTTESVILLE GASTROENTEROLOGY ASSOCIATES PC

MEDICARE: CHARLOTTESVILLE GASTROENTEROLOGY ASSOCIATES PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist2953VA

General Provider Information

NPI Number : 1689671448
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLOTTESVILLE GASTROENTEROLOGY ASSOCIATES PC
Provider Business Mailing Address
First Line : 1139 E HIGH ST
Second Line : SUITE 203
City : CHARLOTTESVILLE
State : VA
Zip : 22902-4856
Country : US
Telephone Number : 434-817-8484
Fax Number : 434-817-8490
Provider Business Practice Location Address
First Line : 1139 E HIGH ST
Second Line : SUITE 203
City : CHARLOTTESVILLE
State : VA
Zip : 22902-4856
Country : US
Telephone Number : 434-817-8484
Fax Number : 434-817-8490
Authorized Official
Title or Position : OWNER
Name : DR. BYRD STUART LEAVELL JR.
Credential : MD
Telephone Number : 434-817-8484
Provider Enumeration Date : 07/07/2005
Last Update Date : 03/27/2008

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Directions to “CHARLOTTESVILLE GASTROENTEROLOGY ASSOCIATES PC ” Practice Location

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