Healthcare Provider Details

I. General information

NPI: 1790728202
Provider Name (Legal Business Name): GEORGE C AGRITELLIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 LINDEN DR STE 108
WINCHESTER VA
22601-6901
US

IV. Provider business mailing address

PO BOX 45923
BALTIMORE MD
21297-5923
US

V. Phone/Fax

Practice location:
  • Phone: 540-722-6200
  • Fax:
Mailing address:
  • Phone: 877-969-0392
  • Fax: 804-658-0582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0056298
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101287250
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: