Individual
LESLIE M BRANDWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7440 SPRING VILLAGE DR, SPRINGFIELD, VA 22150-4446
(703) 923-4644
(703) 923-4625
Mailing address
5249 DUKE STREET, SUITE 100, ALEXANDRIA, VA 22304
(703) 658-2650
(703) 658-2656
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101-022445
VA
207R00000X
Internal Medicine Physician
Primary
0101022445
VA
207RR0500X
Rheumatology Physician
0101022445
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
BCBS-DC
—
01
—
0411220
EVERCARE
—
01
—
1356371496
BCBS-VA
—
01
—
607055-01
BCBS OF MD
MD
Enumeration date
07/04/2006
Last updated
12/03/2015
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