Provider Demographics
NPI:1093927782
Name:BRILL, LOUIS B II (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:B
Last Name:BRILL
Suffix:II
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6607 THACKWELL WAY
Mailing Address - Street 2:UNIT 2210
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-6106
Mailing Address - Country:US
Mailing Address - Phone:434-242-4180
Mailing Address - Fax:
Practice Address - Street 1:6607 THACKWELL WAY
Practice Address - Street 2:UNIT 2210
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-6106
Practice Address - Country:US
Practice Address - Phone:202-463-7872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242320207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPENDINGMedicaid
VAPENDINGMedicare PIN