Provider Demographics
NPI:1043465974
Name:CHURCHILL, AUSTIN LEIGH GIUNTA (MD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN LEIGH
Middle Name:GIUNTA
Last Name:CHURCHILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AUTIN
Other - Middle Name:
Other - Last Name:GIUNTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:502 W BROAD ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3206
Mailing Address - Country:US
Mailing Address - Phone:703-894-2224
Mailing Address - Fax:315-800-5196
Practice Address - Street 1:502 W BROAD ST STE 1B
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3206
Practice Address - Country:US
Practice Address - Phone:703-894-2224
Practice Address - Fax:315-800-5196
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244561208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1043465974Medicaid
176025OtherMEDICARE