Organization
GASTROINTESTINAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA KAY LOWERY (CREDENTIALING MANAGER)
(317) 919-9025
Entity
Organization
Contact information
Practice address
2296 OPITZ BLVD STE 350, WOODBRIDGE, VA 22191-3346
(703) 680-2111
(703) 878-3939
Mailing address
2296 OPITZ BLVD STE 350, WOODBRIDGE, VA 22191-3346
(703) 680-2111
(703) 878-3939
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101027073
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002430
ANTHEM
VA
01
—
0675283010
CIGNA
VA
05
—
1861588592
—
VA
01
—
23890001
CAREFIRST
VA
01
—
4081469
AETNA
VA
01
—
DF9153
RR MEDICARE
VA
Enumeration date
10/04/2006
Last updated
07/10/2026
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