Provider Demographics
NPI:1275601890
Name:BRAWLEY, STEPHEN C (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:BRAWLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-932-5162
Mailing Address - Fax:540-932-5875
Practice Address - Street 1:540 RADFORD LN STE 250
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-7466
Practice Address - Country:US
Practice Address - Phone:434-823-7896
Practice Address - Fax:434-220-5941
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231587207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1275601890OtherUNITED HEALTHCARE
VA1275601890OtherTRICARE/CHAMPUS
VA1275601890OtherCOVENTRY NETWORK
VA1275601890OtherVIRGINIA PREMIER HEALTH PLAN
NC1275601890Medicaid
VA1275601890OtherMULTIPLAN
VA1275601890OtherUSA MANAGED CARE
VA1275601890OtherCIGNA
VA1275601890OtherCORVEL
VA1275601890OtherVIRGINIA HEALTH NETWORK
VA1275601890OtherANTHEM BC/BS
VA1275601890Medicaid
VA1275601890OtherAETNA
VA1275601890OtherOPTIMA HEALTH
NC1275601890Medicaid