Provider Demographics
NPI:1083712053
Name:INTERNAL MEDICINE SPECIALISTS OF WINCHESTER, PC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE SPECIALISTS OF WINCHESTER, PC
Other - Org Name:INTERNAL MEDICINE SPECIALISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-667-6161
Mailing Address - Street 1:1829 W. PLAZA DRIVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6365
Mailing Address - Country:US
Mailing Address - Phone:540-667-6161
Mailing Address - Fax:540-722-2744
Practice Address - Street 1:1829 W. PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6365
Practice Address - Country:US
Practice Address - Phone:540-667-6161
Practice Address - Fax:540-722-2744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CF2015OtherMEDICARE RR
VA099924OtherANTTHEM GROUP NUMBER
CF2015OtherMEDICARE RR