Provider Demographics
NPI:1407812563
Name:SCHUM-BRADY, MARIE LOUISE (MD)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:LOUISE
Last Name:SCHUM-BRADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 14TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-4925
Mailing Address - Country:US
Mailing Address - Phone:703-527-5384
Mailing Address - Fax:703-527-5881
Practice Address - Street 1:3500 14TH ST N
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-4925
Practice Address - Country:US
Practice Address - Phone:703-527-5384
Practice Address - Fax:703-527-5881
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054616208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010196833Medicaid
VA010196833Medicaid
G35431Medicare UPIN