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General NPI Number Information
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NPI Number | 1043465974
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Entity Type | Individual
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Provider Name | AUSTIN LEIGH GIUNTA CHURCHILL M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/19/2008
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 502 W BROAD ST STE 1B
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3206
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Country | US
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Telephone | 703-894-2224
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Fax | 315-800-5196
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Provider Business Mailing Address
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Address Line | 502 W BROAD ST STE 1B
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3206
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Country | US
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Telephone | 703-894-2224
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Fax | 315-800-5196
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 0101244561
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 0101244561
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License Number State | VA
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