| Grace J. Stonerock, Md, Pc | |
|
10696 Crestwood Dr Manassas VA 20109-4411 | |
| (703) 368-7110 | |
| (703) 369-1842 |
| Full Name | Grace J. Stonerock, Md, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 10696 Crestwood Dr, Manassas, Virginia |
| Authorized Official Name and Position | Grace J Stonerock (PRESIDENT/M.D.) |
| Authorized Official Contact | 7033687110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace J. Stonerock, Md, Pc 10696 Crestwood Dr Manassas VA 20109-4411 Ph: (703) 368-7110 | Grace J. Stonerock, Md, Pc 10696 Crestwood Dr Manassas VA 20109-4411 Ph: (703) 368-7110 |
| NPI Number | 1659379105 |
|---|---|
| Provider Enumeration Date | 07/08/2005 |
| Last Update Date | 07/28/2023 |
| Medicare PECOS PAC ID | 6709876345 |
|---|---|
| Medicare Enrollment ID | O20080815000074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659379105 | NPI | - | NPPES |
| 5643732 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101045665 (Virginia) | Primary |
| Provider Name | Grace J Stonerock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629234489 PECOS PAC ID: 2365512027 Enrollment ID: I20080722000755 |
| Provider Name | David A Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548908981 PECOS PAC ID: 3870979933 Enrollment ID: I20230928000848 |
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