Individual
MS. BRIGITTA M STATOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1900 ELECTRIC RD STE 100, SALEM, VA 24153-7474
(540) 774-8660
(540) 774-9195
Mailing address
2013 JEFFERSON ST SW FL 2, ROANOKE, VA 24014-2419
(540) 982-0237
(540) 982-2719
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110005883
VA
363A00000X
Physician Assistant
018560-1
NY
363A00000X
Physician Assistant
MA055021
PA
363AM0700X
Medical Physician Assistant
Primary
0110005883
VA
Other
Enumeration date
11/22/2011
Last updated
11/11/2022
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