Provider Demographics
NPI:1922073162
Name:BRITT, CHARLENE M (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:M
Last Name:BRITT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:816 INDEPENDENCE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6010
Mailing Address - Country:US
Mailing Address - Phone:757-363-6818
Mailing Address - Fax:757-507-9023
Practice Address - Street 1:816 INDEPENDENCE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6010
Practice Address - Country:US
Practice Address - Phone:757-363-6818
Practice Address - Fax:757-507-9023
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2012-01-26
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Provider Licenses
StateLicense IDTaxonomies
VA0101057143207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005632277Medicaid
G71120Medicare UPIN
VA005632277Medicaid