Individual
BRENDAN AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1701 N GEORGE MASON DR, ARLINGTON, VA 22205-3610
(703) 558-5000
Mailing address
1701 N GEORGE MASON DR, ARLINGTON, VA 22205-3610
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110009148
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110009148
LICENSE NUMBER
VA
Enumeration date
02/07/2023
Last updated
02/07/2023
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