Healthcare Provider Details

I. General information

NPI: 1902833577
Provider Name (Legal Business Name): ANNA M GIANTURCO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 04/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 COMMONWEALTH AVE
WILLIAMSBURG VA
23185-5229
US

IV. Provider business mailing address

3998 FAIR RIDGE DR STE 300
FAIRFAX VA
22033-2907
US

V. Phone/Fax

Practice location:
  • Phone: 757-345-3000
  • Fax:
Mailing address:
  • Phone: 516-945-3107
  • Fax: 516-945-3107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101252416
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number21065
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: