Provider Demographics
NPI:1588748016
Name:GASTROENTEROLOGY ASSOC OF CENTRAL VIRGINIA INC
Entity type:Organization
Organization Name:GASTROENTEROLOGY ASSOC OF CENTRAL VIRGINIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHALMERS
Authorized Official - Middle Name:M
Authorized Official - Last Name:NUNN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:434-384-1862
Mailing Address - Street 1:121 NATIONWIDE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4272
Mailing Address - Country:US
Mailing Address - Phone:434-384-1862
Mailing Address - Fax:434-384-7704
Practice Address - Street 1:121 NATIONWIDE DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4272
Practice Address - Country:US
Practice Address - Phone:434-384-1862
Practice Address - Fax:434-384-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty