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General NPI Number Information
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NPI Number | 1639115389
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Entity Type | Individual
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Provider Name | BRIAN MARK SCHENBERG MD
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Gender | Male
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 210 TEMPLE AVE
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2828
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Country | US
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Telephone | 804-520-6137
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Fax | 804-520-7394
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Provider Business Mailing Address
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Address Line | 210 TEMPLE AVE
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2828
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Country | US
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Telephone | 804-520-6137
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Fax | 804-520-7394
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101238784
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License Number State | VA
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