Provider Demographics
NPI:1801962386
Name:COLON AND RECTAL SPECIALISTS LTD
Entity type:Organization
Organization Name:COLON AND RECTAL SPECIALISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:VORENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-288-7077
Mailing Address - Street 1:7605 FOREST AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4938
Mailing Address - Country:US
Mailing Address - Phone:804-288-7077
Mailing Address - Fax:804-285-8120
Practice Address - Street 1:7605 FOREST AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4938
Practice Address - Country:US
Practice Address - Phone:804-288-7077
Practice Address - Fax:804-285-8120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC04411Medicare PIN
CF1951Medicare PIN
VAC04410Medicare PIN