MEDICARE: DR. ARTHUR BRANTZ 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	208D00000X	General Practice Physician	0101035318	VA

General Provider Information

NPI Number	:	1154379287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR BRANTZ M.D.

Provider Business Mailing Address
First Line	:	8735 SHADOW LAWN CT
Second Line	:
City	:	ANNADALE
State	:	VA
Zip	:	22003
Country	:	US
Telephone Number	:	703-323-5608
Fax Number	:

Provider Business Practice Location Address
First Line	:	6020 RICHMOND HIGHWAY
Second Line	:	102
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303
Country	:	US
Telephone Number	:	571-308-6776
Fax Number	:

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	03/27/2017

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