Provider Demographics
NPI:1386613495
Name:BRANCHE, GEORGE C (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:C
Last Name:BRANCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 S SHIRLINGTON RD STE 1000
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3614
Mailing Address - Country:US
Mailing Address - Phone:703-769-8450
Mailing Address - Fax:703-271-9451
Practice Address - Street 1:2800 S SHIRLINGTON RD STE 1100
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3605
Practice Address - Country:US
Practice Address - Phone:703-769-8450
Practice Address - Fax:703-271-9451
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041029174400000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
212635OtherMAMSI
108242OtherAMERIGROUP
2509-0024OtherCAREFIRST ID#
4051008OtherAETNA PPO
VA0013OtherCIGNA
0736883OtherAETNA HMO
VA053885OtherANTHEM
200039700OtherRAILROAD MEDICARE
4051008OtherAETNA PPO
VAC87800Medicare UPIN