Provider Demographics
NPI:1831168012
Name:GREGORY A KUJALA MD PC
Entity type:Organization
Organization Name:GREGORY A KUJALA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUJALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-678-0571
Mailing Address - Street 1:1870 AMHERST STREET
Mailing Address - Street 2:STE 1D
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2841
Mailing Address - Country:US
Mailing Address - Phone:540-678-0571
Mailing Address - Fax:540-722-6649
Practice Address - Street 1:1870 AMHERST STREET
Practice Address - Street 2:STE 1D
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2841
Practice Address - Country:US
Practice Address - Phone:540-678-0571
Practice Address - Fax:540-722-6649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044831207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
504201OtherNCPPO
0070603000OtherWV MEDICAID
VA027859OtherANTHEM BC
VA7063882003OtherCIGNA
2119221OtherMAMSI
VA009516G95Medicare ID - Type Unspecified
VAC09195Medicare ID - Type UnspecifiedGROUP #
VA7063882003OtherCIGNA