Organization
GASTROENTEROLOGY ASSOCIATES VA, LLC
Active
Organization
GASTROENTEROLOGY ASSOCIATES VA, LLC
Active
Other names
Gastroenterology Associates, PC, Colon Stomach & Liver Center, Tidewater Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MATERNA (DIRECTOR, CREDENTIALING)
(901) 377-8219
Entity
Organization
Contact information
Practice address
7915 LAKE MANASSAS DR STE 302, GAINESVILLE, VA 20155-3260
(571) 248-0653
(571) 248-0658
Mailing address
PO BOX 381468, GERMANTOWN, TN 38183-1468
(901) 328-1355
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101027526
VA
207RG0100X
Gastroenterology Physician
Primary
0101027526
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518990472
—
VA
Enumeration date
07/07/2006
Last updated
02/10/2026
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