MEDICARE: CORNERSTONE SPORTS AND ORTHOPAEDIC SURGERY OF WINCHESTER PC

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
1	207X00000X	Orthopaedic Surgery Physician		VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376821819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE SPORTS AND ORTHOPAEDIC SURGERY OF WINCHESTER PC

Provider Business Mailing Address
First Line	:	650 CEDAR CREEK GRADE
Second Line	:	SUITE 213
City	:	WINCHESTER
State	:	VA
Zip	:	22601-6454
Country	:	US
Telephone Number	:	540-323-7463
Fax Number	:	540-323-7459

Provider Business Practice Location Address
First Line	:	650 CEDAR CREEK GRADE
Second Line	:	SUITE 213
City	:	WINCHESTER
State	:	VA
Zip	:	22601-6454
Country	:	US
Telephone Number	:	540-323-7463
Fax Number	:	540-323-7459

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	DOUGLAS D DUNCAN
Credential	:	MD
Telephone Number	:	540-532-6712

Provider Enumeration Date	:	08/02/2011
Last Update Date	:	09/26/2011

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