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NPI Code Detail

MEDICARE: VICTOR M BRUGH MD

MEDICARE:   VICTOR M BRUGH  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
1208800000XUrology Physician0101056141VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4004770E81OTHERVAEVMS VA MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
171246OTHEREVMS SENTARA/OPTIMA
21902884133OTHERVAANTHEM HEALTHKEEPERS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6066KMOTHERNCEVMS NC BC/BS
7465721OTHERVAANTHEM BC BS
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9137412OTHEREVMS ANTHEM BC/BS
1065653OTHERVASENTARA HEALTHCARE

General Provider Information

NPI Number : 1902884133
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTOR M BRUGH MD
Provider Business Mailing Address
First Line : 225 CLEARFIELD AVE
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-1815
Country : US
Telephone Number : 757-457-5100
Fax Number : 757-961-3934
Provider Business Practice Location Address
First Line : 225 CLEARFIELD AVE
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-1815
Country : US
Telephone Number : 757-457-5100
Fax Number : 757-961-3934
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 03/23/2018

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