Provider Demographics
NPI:1952455735
Name:GASTROENTEROLOGY ASSOCIATES OF FREDERICKSBURG, P.C.
Entity Type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES OF FREDERICKSBURG, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:DETRANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-371-7600
Mailing Address - Street 1:1031 CARE WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8425
Mailing Address - Country:US
Mailing Address - Phone:540-371-7600
Mailing Address - Fax:540-371-2046
Practice Address - Street 1:1031 CARE WAY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8425
Practice Address - Country:US
Practice Address - Phone:540-371-7600
Practice Address - Fax:540-371-2046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1952455735Medicare PIN