Provider Demographics
NPI:1366419921
Name:BRASSEL, ALFRED L JR (MD)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:L
Last Name:BRASSEL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2348 YORK CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072
Mailing Address - Country:US
Mailing Address - Phone:804-684-2000
Mailing Address - Fax:804-684-2059
Practice Address - Street 1:2348 YORK CROSSING DR
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072
Practice Address - Country:US
Practice Address - Phone:804-684-2000
Practice Address - Fax:804-684-2059
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101019808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
003006S33Medicare ID - Type Unspecified
H11090Medicare UPIN