Provider Demographics
NPI:1023081536
Name:BRENBRIDGE, NORMAN A (MD)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:A
Last Name:BRENBRIDGE
Suffix:
Gender:M
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:PO BOX 2546
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23450-2546
Mailing Address - Country:US
Mailing Address - Phone:434-244-4580
Mailing Address - Fax:434-244-4579
Practice Address - Street 1:500 MARTHA JEFFERSON DR
Practice Address - Street 2:CHARLOTTESVILLE RADIOLOGY
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4668
Practice Address - Country:US
Practice Address - Phone:434-244-4580
Practice Address - Fax:434-244-4579
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010251072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA300020065OtherRR MED
VA00723128Medicaid
VA300000566Medicare PIN
VA300020065OtherRR MED