Provider Demographics
NPI:1598734733
Name:KUJALA, GREGORY A (MD)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:A
Last Name:KUJALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1870 AMHERST ST
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2841
Mailing Address - Country:US
Mailing Address - Phone:540-678-0571
Mailing Address - Fax:540-722-6649
Practice Address - Street 1:1870 AMHERST ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2841
Practice Address - Country:US
Practice Address - Phone:540-678-0571
Practice Address - Fax:540-722-6649
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101044831207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7063882003OtherCIGNA
2119221OtherMAMSI
0070603000OtherWV MEDICAID
VA027859OtherANTHEM BC
504201OtherPVCPPO
VA027859OtherANTHEM BC
VA00916G95Medicare ID - Type Unspecified