Provider Demographics
NPI:1902833577
Name:GIANTURCO, ANNA M (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:GIANTURCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3998 FAIR RIDGE DR
Mailing Address - Street 2:STE 300
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2907
Mailing Address - Country:US
Mailing Address - Phone:516-945-3107
Mailing Address - Fax:516-945-3107
Practice Address - Street 1:1500 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5229
Practice Address - Country:US
Practice Address - Phone:757-345-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101252416207L00000X
WV21065207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001706469OtherMSBCBS GROUP
VA1902833577Medicaid
WVDA0096OtherRR MEDICARE
WV2004028000Medicaid
WV7925403OtherAETNA
WV1070944OtherBRICKSTREET
WV205542387000OtherBRICKSTREET GROUP
WV270052997004OtherTRICARE
WV20554238700OtherWORKERS COMP
WV2782663OtherOHIO MEDICAID
WVP00370037OtherRR MEDICARE
WV001720743OtherBCBS - MAAC
WV001907643OtherMSBCBS GROUP
WV0207026000Medicaid
WV205542387OtherWORKERS COMP
WV27005299700OtherBRICKSTREET GROUP
WV3810006746Medicaid
WVDA0096OtherRR MEDICARE
VA1902833577Medicaid
WV3810006746Medicaid
WV9364011Medicare PIN
WV4104224Medicare PIN