Provider Demographics
NPI:1043423577
Name:ROBERT W. GURNEY,M.D.,LTD.
Entity Type:Organization
Organization Name:ROBERT W. GURNEY,M.D.,LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-437-7744
Mailing Address - Street 1:11315 SUNSET HILLS RD
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5205
Mailing Address - Country:US
Mailing Address - Phone:703-437-7744
Mailing Address - Fax:
Practice Address - Street 1:11315 SUNSET HILLS RD
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5205
Practice Address - Country:US
Practice Address - Phone:703-437-7744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029583207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB93755Medicare UPIN
VA158490Medicare ID - Type Unspecified