Individual
GEORGE ALEXANDER BENTREM II
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12515 TIMBER WAY, RT 259, BROADWAY, VA 22815
(540) 896-7061
(540) 896-7062
Mailing address
12515 TIMBER WAY RT 259, PO BOX 6, BROADWAY, VA 22815
(540) 896-7061
(540) 896-7062
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101054180
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5619734
—
VA
Enumeration date
02/15/2006
Last updated
07/09/2007
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