| Gastroenterology Associates Pllc | |
|
19500 Sandridge Way Ste 470 Leesburg VA 20176-3694 | |
| (703) 771-9001 | |
| (703) 771-9076 |
| Full Name | Gastroenterology Associates Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 19500 Sandridge Way Ste 470, Leesburg, Virginia |
| Authorized Official Name and Position | Stephen J Antonik (PRESIDENT) |
| Authorized Official Contact | 7037719001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Associates Pllc 19500 Sandridge Way Ste 470 Leesburg VA 20176-3694 Ph: (703) 771-9001 | Gastroenterology Associates Pllc 19500 Sandridge Way Ste 470 Leesburg VA 20176-3694 Ph: (703) 771-9001 |
| NPI Number | 1497853303 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 10/06/2021 |
| Medicare PECOS PAC ID | 3779514971 |
|---|---|
| Medicare Enrollment ID | O20050827000053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497853303 | NPI | - | NPPES |
| 203434 | Other | VA | ANTHEM BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Stephen J Antonik |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770567257 PECOS PAC ID: 4486670288 Enrollment ID: I20090729000494 |
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