Provider Demographics
NPI:1689647166
Name:BRUSH, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:BRUSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:205 BUSINESS PARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6535
Mailing Address - Country:US
Mailing Address - Phone:757-962-1083
Mailing Address - Fax:757-962-1254
Practice Address - Street 1:844 KEMPSVILLE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3927
Practice Address - Country:US
Practice Address - Phone:757-261-0700
Practice Address - Fax:757-962-1254
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2009-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101047932207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0500MOtherBC/BS NC
VA15936OtherOPTIMA
VA250144OtherANTHEM
VA006040039Medicaid
VA092965OtherANTHEM BCBS
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherMULTIPLAN
VA15792OtherSENTARA OHP/SHP
VA249506OtherMAMSI
NC890500MMedicaid
VAPAROtherCIGNA
VAPAROtherVIRGINA HEALTH NETWORK
VA006084664Medicaid
VAPAROtherUSA MANAGED CARE
VA-001OtherTRICARE/CHAMPUS (EVMS HEALTH SERVICES)
VAPAROtherCORVEL/CORCARE
VA263654OtherUHC/MAMSI/MDIPA
VAPAROtherAETNA
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA110131265Medicare PIN
VA-001OtherTRICARE/CHAMPUS (EVMS HEALTH SERVICES)
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA006040039Medicaid
VA110006052Medicare PIN