MEDICARE: WINCHESTER EAR, NOSE & THROAT CENTER, PLLC

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	174400000X	Specialist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	601481700	OTHER	VA	MEDICARE RR

General Provider Information

NPI Number	:	1841242591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINCHESTER EAR, NOSE & THROAT CENTER, PLLC

Provider Business Mailing Address
First Line	:	2055 VALLEY AVENUE
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-2751
Country	:	US
Telephone Number	:	540-667-7200
Fax Number	:	540-667-6377

Provider Business Practice Location Address
First Line	:	2055 VALLEY AVENUE
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-2751
Country	:	US
Telephone Number	:	540-667-7200
Fax Number	:	540-667-6377

Authorized Official
Title or Position	:	M.D./OWNER
Name	:	MATTHEW E. KAREN
Credential	:	M.D.
Telephone Number	:	540-667-7200

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	08/25/2009

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