Individual
WILLIAM CLARENCE BRINK
Active
Individual
WILLIAM CLARENCE BRINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101054044
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000433417
WV BLUE SHIELD
WV
05
—
006051987
—
VA
05
—
0079497000
—
WV
01
—
08243600000
QUALCHOICE PROFESSIONAL
—
01
—
211017
ANTHEM PROFESSIONAL
—
01
—
2119631
MAMSI PROFESSIONAL
—
01
—
3810003817
WV MEDICAID GROUP
WV
01
—
43936
SENTARA PROFESSIONAL
—
01
—
C00085
MEDICARE GROUP
VA
Enumeration date
04/21/2006
Last updated
03/03/2021
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