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General NPI Number Information
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NPI Number | 1689647166
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Entity Type | Individual
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Provider Name | JOHN E BRUSH MD
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Gender | Male
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 02/19/2009
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Provider Practice Location Address
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Address Line | 844 KEMPSVILLE RD SUITE 204
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City | NORFOLK
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State | VA
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Zip | 23502-3927
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Country | US
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Telephone | 757-261-0700
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Fax | 757-962-1254
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Provider Business Mailing Address
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Address Line | 205 BUSINESS PARK DR SUITE 200
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6535
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Country | US
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Telephone | 757-962-1083
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Fax | 757-962-1254
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101047932
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License Number State | VA
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