Provider Demographics
NPI:1326139577
Name:WINCHESTER CARDIOTHORACIC AND VASCULAR SURGEONS, PLC
Entity Type:Organization
Organization Name:WINCHESTER CARDIOTHORACIC AND VASCULAR SURGEONS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:DENTON
Authorized Official - Last Name:STAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-536-6721
Mailing Address - Street 1:1870 AMHERST ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2873
Mailing Address - Country:US
Mailing Address - Phone:540-536-6721
Mailing Address - Fax:540-536-6724
Practice Address - Street 1:1870 AMHERST ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2873
Practice Address - Country:US
Practice Address - Phone:540-536-6721
Practice Address - Fax:540-536-6724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101224774173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty