Provider Demographics
NPI:1154381754
Name:TSCHIRGI, LAUREL
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:TSCHIRGI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 CEDAR CREEK GRADE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601
Mailing Address - Country:US
Mailing Address - Phone:540-723-0611
Mailing Address - Fax:540-723-9875
Practice Address - Street 1:905 CEDAR CREEK GRADE
Practice Address - Street 2:SUITE 101
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-723-0611
Practice Address - Fax:540-723-9875
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034817207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B93140Medicare UPIN
VA00X133L01Medicare PIN
110039045Medicare PIN