George Alexander Bentrem II, M.D.
Individual provider Active NPI Family Medicine Physician · Broadway, VA
NPI 1699749648 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1699749648
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101054180 (VA)
- Practice address
- 12515 Timber Way
RT 259
Broadway, VA 22815 - Phone
- (540) 896-7061
- Fax
- (540) 896-7062
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101054180 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broadway Family Practice, PC | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101054180 | VA | Yes |
Addresses
Primary practice location
12515 Timber Way
RT 259
Broadway, VA 22815
Mailing address
12515 Timber Way RT 259
PO Box 6
Broadway, VA 22815
Phone (540) 896-7061
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5619734 | Medicaid | VA |
Other providers in Broadway, VA
- Jenelle L Alderfer
- Appalachian Physical Therapy, Inc.
- Appalachian Physical Therapy, Inc.
- Ann Elizabeth Baker
- Robin Bell
- Bickham Counseling PLLC
- Joanna Bickham
- Megan Bonaventura
- Broadway Drug Center, LLC
- Broadway Drug Center, LLC
All providers in Broadway, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.