Provider Demographics
NPI:1972577070
Name:CHARLOTTESVILLE NEUROLOGY AND SLEEP MEDICINE PC
Entity Type:Organization
Organization Name:CHARLOTTESVILLE NEUROLOGY AND SLEEP MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-293-9149
Mailing Address - Street 1:1410 ROLKIN CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-3587
Mailing Address - Country:US
Mailing Address - Phone:434-654-7794
Mailing Address - Fax:434-654-7752
Practice Address - Street 1:1410 ROLKIN CT
Practice Address - Street 2:SUITE 101
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3574
Practice Address - Country:US
Practice Address - Phone:434-293-9149
Practice Address - Fax:434-293-9140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADC0527Medicare PIN
VAC03229Medicare PIN