Provider Demographics
NPI:1255582136
Name:GARY SCHEIB LLC
Entity type:Organization
Organization Name:GARY SCHEIB LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SCHEIB
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:703-431-7102
Mailing Address - Street 1:22009 BLUERIDGE MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:VA
Mailing Address - Zip Code:20130-1736
Mailing Address - Country:US
Mailing Address - Phone:703-431-7102
Mailing Address - Fax:
Practice Address - Street 1:22009 BLUERIDGE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:VA
Practice Address - Zip Code:20130-1736
Practice Address - Country:US
Practice Address - Phone:703-431-7102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300910213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU99210Medicare UPIN