Brian W Mandeville Jr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101239244 Issued in VA

Practice address

2215 Landover PL
Lynchburg, VA 24501-2115

Phone

(434) 947-3944

Fax

(866) 617-8273

NPI assigned

Mar 21, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1356683957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 LANDOVER PL",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012115",
            "telephone_number": "434-947-3944",
            "fax_number": "866-617-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 LANDOVER PL",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012115",
            "telephone_number": "434-947-3944",
            "fax_number": "866-617-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEVILLE",
        "first_name": "BRIAN",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101239244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356683957",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Ann Malone, M.A., BCBA
• Stephannie Malone
• Joy Bernhart Maloy, LPC
• Myrrh Manaytay, LPC
• Laura Faith Mancuso, ATC
• Morgan S Mandeville, M.D.
• Michael Niccolo Ramos Mangubat, M.D.
• Pamela Dawn Mangus, LPC
• James A Mankus, DPT, PT
• Andrew Mann

• Internal Medicine Physician in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.