Healthcare Provider Details

I. General information

NPI: 1497955348
Provider Name (Legal Business Name): ROBERT S BRINDLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 RIVERMONT AVE
LYNCHBURG VA
24503-2030
US

IV. Provider business mailing address

3300 RIVERMONT AVE
LYNCHBURG VA
24503-2030
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-4072
  • Fax:
Mailing address:
  • Phone: 434-200-4072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101254161
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: