Provider Demographics
NPI:1023372232
Name:NEWBERRY, BRIAN SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:SCOTT
Last Name:NEWBERRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1490 PARK AVE NW
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1631
Mailing Address - Country:US
Mailing Address - Phone:276-679-8890
Mailing Address - Fax:276-679-9740
Practice Address - Street 1:1490 PARK AVE NW
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1631
Practice Address - Country:US
Practice Address - Phone:276-679-8890
Practice Address - Fax:276-679-9740
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2017-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102204161207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1023372232Medicaid
VAVVI335BMedicare PIN
VAVVI335CMedicare PIN
VAVVI335AMedicare PIN