Provider Demographics
NPI:1821226937
Name:PIELECK, ANDREW WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WILLIAM
Last Name:PIELECK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 GRAVES MILL RD
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-2675
Mailing Address - Country:US
Mailing Address - Phone:434-316-7199
Mailing Address - Fax:434-316-6185
Practice Address - Street 1:2103 GRAVES MILL RD
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2675
Practice Address - Country:US
Practice Address - Phone:434-316-7199
Practice Address - Fax:434-316-6185
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102203496207QS0010X
VA0116021714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty