Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 0101244561 | VA |
Y | 2081P2900X | Pain Medicine | 0101244561 | VA |
NPI | 1043465974 |
---|---|
Provider Name | Dr. Austin Leigh Giunta Churchill |
First Address | Great Falls, VA 22066-2643 |
Second Address | Great Falls, VA 22066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2008 |
Last Update Date | 06/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043465974 | (05) | VA |
176025 | MEDICARE (01) |