Individual
DR. BRIAN EDUARDO GODINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2722 MERRILEE DR STE 230, FAIRFAX, VA 22031-4400
(703) 698-4444
(703) 204-0116
Mailing address
2722 MERRILEE DR STE 230, FAIRFAX, VA 22031-4400
(703) 698-4444
(703) 204-0116
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101255863
VA
2085R0202X
Diagnostic Radiology Physician
01068019A
IN
2085R0202X
Diagnostic Radiology Physician
D0087350
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174785521
—
VA
01
—
P01337337
RAILROAD MEDICARE
IN
Enumeration date
06/26/2008
Last updated
02/04/2022
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