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NPI Code Detail

MEDICARE: ROCKY RUN FAMILY MEDICINE INC

MEDICARE: ROCKY RUN FAMILY MEDICINE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1173000000XLegal Medicine144870VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18094-0001OTHERVACAREFIRST
28094-0002OTHERVACAREFIRST
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4383306OTHERVAANTHEM BC/BS
58094-0004OTHERVACAREFIRST
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8383307OTHERVAANTHEM BC/BS
9383308OTHERVAANTHEM BC/BS

General Provider Information

NPI Number : 1043234552
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKY RUN FAMILY MEDICINE INC
Provider Business Mailing Address
First Line : 5645 STONE RD
Second Line :
City : CENTREVILLE
State : VA
Zip : 20120-1618
Country : US
Telephone Number : 703-266-2442
Fax Number : 703-266-7158
Provider Business Practice Location Address
First Line : 5645 STONE RD
Second Line :
City : CENTREVILLE
State : VA
Zip : 20120-1618
Country : US
Telephone Number : 703-266-2442
Fax Number : 703-266-7158
Authorized Official
Title or Position : PRESIDENT
Name : MRS. LAURIE SUSAN MARKIN
Credential : M.D.
Telephone Number : 703-266-2442
Provider Enumeration Date : 07/27/2006
Last Update Date : 03/11/2025

Similar Medicare Providers

1861484461 — DR. SANDOR SHAWN NIEMANN MD
Practice Location Address:
5645 STONE RD
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20120-1618
Practice Phone: 703-266-2442
Practice Fax: 703-266-7158
1083608954 — DR. COURTNEY KATHERINE RYAN MD
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1629037171 — MRS. LAURIE SUSAN MARKIN MD
Practice Location Address:
5645 STONE RD
CENTREVILLE, VA
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Practice Phone: 703-266-2442
Practice Fax: 703-266-7158
1326009986 — ROBERT C MANCINI MD
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1679673255 — STACEY T SHEPHERD PA-C
Practice Location Address:
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1497988588 — SKINNER OSSAKOW & ASSOCIATES
Practice Location Address:
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Practice Fax: 703-930-0601

Directions to “ROCKY RUN FAMILY MEDICINE INC ” Practice Location

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