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NPI Code Detail

MEDICARE: VIRGINIA GAIL BRONAUGH P.D.

MEDICARE: VIRGINIA GAIL BRONAUGH P.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
1183500000XPharmacist8933MD

General Provider Information

NPI Number : 1447220181
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIRGINIA GAIL BRONAUGH P.D.
Provider Business Mailing Address
First Line : 3305 N LEISURE WORLD BLVD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20906-1367
Country : US
Telephone Number : 301-598-1590
Fax Number :
Provider Business Practice Location Address
First Line : 3305 N LEISURE WORLD BLVD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20906-1367
Country : US
Telephone Number : 301-598-1550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 11/19/2007

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Directions to “ VIRGINIA GAIL BRONAUGH P.D.” Practice Location

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