Healthcare Provider Details

I. General information

NPI: 1306155197
Provider Name (Legal Business Name): GIL ASCUNCE, MD, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2010
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 N GEORGE MASON DR STE 410
ARLINGTON VA
22205-3666
US

IV. Provider business mailing address

1715 N GEORGE MASON DR STE 410
ARLINGTON VA
22205-3666
US

V. Phone/Fax

Practice location:
  • Phone: 703-524-4792
  • Fax: 703-276-7487
Mailing address:
  • Phone: 703-524-4792
  • Fax: 703-276-7487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101029897
License Number StateVA

VIII. Authorized Official

Name: DR. GIL ASCUNCE
Title or Position: PRESIDENT
Credential: M.D
Phone: 703-524-4792