Provider Demographics
NPI:1386638641
Name:BURIJON, BRIAN G (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:G
Last Name:BURIJON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4619 CHESTER SQUARE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1726
Mailing Address - Country:US
Mailing Address - Phone:807-778-4747
Mailing Address - Fax:804-778-4487
Practice Address - Street 1:4619 CHESTER SQUARE RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1726
Practice Address - Country:US
Practice Address - Phone:804-778-4747
Practice Address - Fax:804-778-4487
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-052854207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00X806C01Medicare PIN