Provider Demographics
NPI:1023008182
Name:PULMONARY AND CRITICAL CARE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:PULMONARY AND CRITICAL CARE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RENNERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-858-9608
Mailing Address - Street 1:19455 DEERFIELD AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8102
Mailing Address - Country:US
Mailing Address - Phone:703-858-9608
Mailing Address - Fax:703-858-9618
Practice Address - Street 1:19455 DEERFIELD AVE STE 206
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8102
Practice Address - Country:US
Practice Address - Phone:703-858-9608
Practice Address - Fax:703-858-9618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043761207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CH3994Medicare ID - Type UnspecifiedRR MEDICARE
VAC06598Medicare ID - Type UnspecifiedVA MEDICARE
DCG00437Medicare ID - Type UnspecifiedDC MEDICARE
VA5374410001Medicare NSC