Healthcare Provider Details
I. General information
NPI: 1942272893
Provider Name (Legal Business Name): LUNZY DELANO BRITT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/06/2006
Last Update Date: 11/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
825 FAIRFAX AVE SUITE 610
NORFOLK VA
23507-1914
US
IV. Provider business mailing address
PO BOX 936
NORFOLK VA
23501-0936
US
V. Phone/Fax
- Phone: 757-446-8950
- Fax: 757-446-5197
- Phone: 757-446-8950
- Fax: 757-446-5197
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 0101037632 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | 0101037632 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: