Healthcare Provider Details

I. General information

NPI: 1992964704
Provider Name (Legal Business Name): ALAN A BRIJBASSIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MEDICAL CENTER CIR STE 302
FISHERSVILLE VA
22939-2273
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-245-7350
  • Fax: 540-245-7360
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101251502
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: