Individual
DR. DOUGLAS SPENCER BRUDNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 289-1400
(703) 289-1414
Mailing address
2730-B PROSPERITY A VENUE, FAIRFAX, VA 22031-2238
(703) 289-1400
(703) 289-1414
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
0101231080
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6718167
—
VA
05
—
6719996
—
VA
05
—
6720093
—
VA
Enumeration date
05/27/2006
Last updated
07/08/2007
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