Organization
WINCHESTER INTERNAL MEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD PAUL SMITH MD (PRESIDENT)
(540) 662-6135
Entity
Organization
Contact information
Practice address
190 CAMPUS BLVD, SUITE 200, WINCHESTER, VA 22601-2872
(540) 662-6135
(540) 662-5845
Mailing address
190 CAMPUS BLVD, SUITE 200, WINCHESTER, VA 22601-2872
(540) 662-6135
(540) 662-5845
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
VA
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000875693
MTN STATE BS PAY VA GRP
WV
05
—
3810003817
—
WV
01
—
CB4305
RAILROAD MEDICARE GROUP
—
Enumeration date
05/15/2006
Last updated
06/02/2010
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