1982690194 NPI number — DR. JOHN SILVIUS CIURASH M.D.

Table of content: DR. JOHN SILVIUS CIURASH M.D. (NPI 1982690194)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982690194 NPI number — DR. JOHN SILVIUS CIURASH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CIURASH
Provider First Name:
JOHN
Provider Middle Name:
SILVIUS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982690194
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/24/2006
NPI Reactivation Date:
03/30/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12801 IRON BRIDGE RD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
CHESTER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23831-1669
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-777-9908
Provider Business Mailing Address Fax Number:
804-777-9056

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12801 IRON BRIDGE RD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
CHESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23831-1669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-777-9908
Provider Business Practice Location Address Fax Number:
804-777-9056
Provider Enumeration Date:
09/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  0101050490 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8127435 . This is a "MAMSI HMO PCP NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 2127495 . This is a "MAMSI PROVIDER NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4287866 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 103405 . This is a "BLUE CROSS PROVIDER NUMBE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1406108 . This is a "CIGNA PROVIDER NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 249053 . This is a "BLUE CROSS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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