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Individual

ILIA A. BRUSILOVSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1250 E MARSHALL ST, RICHMOND, VA 23298-5051
(804) 828-9783
Mailing address
PO BOX 980695, RICHMOND, VA 23298-0695
(804) 828-9160

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101247052
VA

Other

Enumeration date
06/16/2008
Last updated
06/19/2013
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