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NPI Code Detail

MEDICARE: DR. EMAD M BOTROS MD

MEDICARE: DR. EMAD M BOTROS MD
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
1207R00000XInternal Medicine Physician101232257VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12119569OTHERVAMAMSI
2466395OTHERVAANTHEM BCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5617226OTHERVANCPPO
6226151OTHERVASOUTHERN HEALTH
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
872594OTHERVACOMMUNITYHEALTH SENTARA

General Provider Information

NPI Number : 1528063070
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMAD M BOTROS MD
Provider Business Mailing Address
First Line : 104 SELMA DR
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-3834
Country : US
Telephone Number : 540-678-2800
Fax Number :
Provider Business Practice Location Address
First Line : 104 SELMA DR
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-3834
Country : US
Telephone Number : 540-678-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 03/05/2021

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