MEDICARE: STANLEY L BRITTMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101028006	VA

General Provider Information

NPI Number	:	1558333401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANLEY L BRITTMAN MD

Provider Business Mailing Address
First Line	:	PO BOX 936
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23501-0936
Country	:	US
Telephone Number	:	757-397-6344
Fax Number	:	757-606-1185

Provider Business Practice Location Address
First Line	:	3640 HIGH ST STE 3B
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-3213
Country	:	US
Telephone Number	:	757-397-6344
Fax Number	:	757-606-1185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	03/19/2018

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