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NPI Code Detail

MEDICARE: DR. LISA K BRATH M.D.

MEDICARE:  DR. LISA K BRATH  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
1207R00000XInternal Medicine Physician0101044965VA
2207RC0200XCritical Care Medicine (Internal Medicine) Physician0101044965VA
3207RP1001XPulmonary Disease Physician0101044965VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700967346
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA K BRATH M.D.
Provider Business Mailing Address
First Line : PO BOX 91734
Second Line :
City : RICHMOND
State : VA
Zip : 23291-1734
Country : US
Telephone Number : 804-358-6100
Fax Number : 804-342-7619
Provider Business Practice Location Address
First Line : 1250 E MARSHALL ST
Second Line : INTERNAL MEDICINE
City : RICHMOND
State : VA
Zip : 23298-0051
Country : US
Telephone Number : 804-828-2161
Fax Number : 804-828-3673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 12/10/2008

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