Provider Demographics
NPI:1386777548
Name:ANSHU GULERIA MD LLC
Entity type:Organization
Organization Name:ANSHU GULERIA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-393-0700
Mailing Address - Street 1:8525 ROLLING ROAD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110
Mailing Address - Country:US
Mailing Address - Phone:703-393-0700
Mailing Address - Fax:703-393-0661
Practice Address - Street 1:8525 ROLLING ROAD
Practice Address - Street 2:SUITE 220
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110
Practice Address - Country:US
Practice Address - Phone:703-393-0700
Practice Address - Fax:703-393-0661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA146956OtherDR GULERIA FOR ANTHEMBCBS
VA146951OtherDR.CHUNG FOR ANTHEMBC BS
VAE88845Medicare UPIN
VAG00762Medicare ID - Type UnspecifiedMETRO DC MEDICARE GRP.
VA00W774A02Medicare ID - Type UnspecifiedDR.CHUNG FOR MANASSAS
VA00W773A01Medicare ID - Type UnspecifiedDR.GULERIA FOR MANASSAS,
VA00A974A62Medicare ID - Type UnspecifiedMETRO DC FOR DR.GULERIA
VAC09686Medicare ID - Type UnspecifiedVIRGINIA GROUP NO.
VA146951OtherDR.CHUNG FOR ANTHEMBC BS
VAI17858Medicare UPIN