Provider Demographics
NPI:1356315980
Name:BUCHANAN, BRIAN D (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:D
Last Name:BUCHANAN
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 1:1710 WHITFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-1401
Mailing Address - Country:US
Mailing Address - Phone:540-586-8889
Mailing Address - Fax:540-586-8717
Practice Address - Street 1:1710 WHITFIELD DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-1401
Practice Address - Country:US
Practice Address - Phone:540-586-8889
Practice Address - Fax:540-586-8717
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101032060207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010015961Medicaid
VA010109132Medicaid
VA145692OtherANTHEM
VA002605B85Medicare PIN
VA145692OtherANTHEM
VA010109132Medicaid