Provider Demographics
NPI:1255396222
Name:LANDRIO, JULIE ANN (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:LANDRIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:GUGLIELMETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:333 W CORK ST UNIT 405
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3876
Mailing Address - Country:US
Mailing Address - Phone:540-313-9200
Mailing Address - Fax:540-678-0772
Practice Address - Street 1:333 W CORK ST UNIT 405
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3876
Practice Address - Country:US
Practice Address - Phone:540-313-9200
Practice Address - Fax:540-678-0772
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005812691Medicaid
VA110007059Medicare ID - Type Unspecified
VA005812691Medicaid