Healthcare Provider Details

I. General information

NPI: 1003891854
Provider Name (Legal Business Name): EMANUEL CIRENZA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 BEAM LN STE 300
FISHERSVILLE VA
22939-2350
US

IV. Provider business mailing address

PO BOX 748613
ATLANTA GA
30384-8613
US

V. Phone/Fax

Practice location:
  • Phone: 434-297-9999
  • Fax: 434-297-9898
Mailing address:
  • Phone: 434-295-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101039001
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number0101039001
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number0101039001
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number0101039001
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: