Individual
DR. BRENDAN MICHAEL MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
4030 GEORGE WASHINGTON MEM HWY STE B, YORKTOWN, VA 23692-2619
(757) 898-5500
(757) 898-8001
Mailing address
730 THIMBLE SHOALS BLVD, SUITE 130, NEWPORT NEWS, VA 23606-4562
(757) 873-1554
(757) 873-3239
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000726
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009300104
—
VA
01
—
1194731042
BLUE CROSS BLUE SHIELD
VA
01
—
4122283
AETNA
VA
01
—
480006732
RAILROAD MEDICARE
VA
Enumeration date
07/31/2006
Last updated
07/05/2022
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