MEDICARE: DR. ROBIN ELIZABETH BRODIE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101047636	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	259950	OTHER	UNITED HEALTHCARE MAMSI
3	50320002	OTHER	CAREFIRST
4	334843	OTHER	ANTHEM HEALTHKEEPERS PLUS
5	480340	OTHER	AETNA
6	8154105	OTHER	UNITED HEALTHCARE MAMSI
7	2154105	OTHER	UNITED HEALTH CARE

General Provider Information

NPI Number	:	1073676771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBIN ELIZABETH BRODIE M.D.

Provider Business Mailing Address
First Line	:	8650 SUDLEY RD
Second Line	:	SUITE 306
City	:	MANASSAS
State	:	VA
Zip	:	20110-4419
Country	:	US
Telephone Number	:	703-393-9494
Fax Number	:	703-393-8591

Provider Business Practice Location Address
First Line	:	8650 SUDLEY RD
Second Line	:	SUITE 306
City	:	MANASSAS
State	:	VA
Zip	:	20110-4419
Country	:	US
Telephone Number	:	703-393-9494
Fax Number	:	703-393-8591

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. ROBIN ELIZABETH BRODIE M.D.” Practice Location

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