Healthcare Provider Details

I. General information

NPI: 1841029006
Provider Name (Legal Business Name): LLIAM BARRETT BRANNIGAN MBBCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2024
Last Update Date: 07/27/2024
Certification Date: 07/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 800710 ANESTHESIA DEPARTMENT UVA
CHARLOTTESVILLE VA
22908-0001
US

IV. Provider business mailing address

PO BOX 800710
CHARLOTTESVILLE VA
22908-0710
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-2283
  • Fax: 434-982-0019
Mailing address:
  • Phone: 434-924-2283
  • Fax: 434-982-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number0109542122
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: