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General NPI Number Information
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NPI Number | 1386778074
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Entity Type | Organization
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Legal Business Name | MONUMENT RADIOLOGY PC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 11/21/2007
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Provider Practice Location Address
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Address Line | 7231 FOREST AVE #102
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City | RICHMOND
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State | VA
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Zip | 23226
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Country | US
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Telephone | 804-288-8321
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Fax | 804-285-3245
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Provider Business Mailing Address
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Address Line | 7231 FOREST AVE #102
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City | RICHMOND
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State | VA
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Zip | 23226
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Country | US
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Telephone | 804-288-8321
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Fax | 804-285-3245
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DIRCK L BRENDLINGER
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Credential | MD
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Telephone | 804-288-8321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 010104003
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License Number State | VA
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