Basic Information
| Provider Information | |||||||||
| NPI: | 1972577070 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHARLOTTESVILLE NEUROLOGY AND SLEEP MEDICINE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1410 ROLKIN CT | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229113587 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4346547794 | ||||||||
| FaxNumber: | 4346547752 | ||||||||
| Practice Location | |||||||||
| Address1: | 1410 ROLKIN CT | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229113574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4342939149 | ||||||||
| FaxNumber: | 4342939140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2006 | ||||||||
| LastUpdateDate: | 07/29/2015 | ||||||||
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| AuthorizedOfficialLastName: | WINTER | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4342939149 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | VA | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084S0012X | VA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Sleep Medicine |
No ID Information.