Per Gunnar Brolinson, D.O.

Individual provider Active NPI Sports Medicine (Neuromusculoskeletal Medicine) Physician · Blacksburg, VA

NPI 1477633832 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1477633832
Entity type
Individual (NPI type 1)
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X
License
0102201326 (VA)
Practice address
101 Professional Park Dr SE
Suite 3
Blacksburg, VA 24060-6685
Phone
(540) 951-4000
Fax
(540) 633-1524
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102201326VAMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Alan Stockard PC Neuromusculoskeletal Medicine, Sports Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 0102201326 VA Yes

Addresses

Primary practice location

101 Professional Park Dr SE
Suite 3
Blacksburg, VA 24060-6685

Mailing address

PO Box 1572
Radford, VA 24143-1572
Phone (540) 639-6736

Other providers in Blacksburg, VA

All providers in Blacksburg, VA · Sports Medicine (Neuromusculoskeletal Medicine) Physician in Virginia

Sources for this page

Verify at the official NPI Registry.