Provider Demographics
NPI:1699755884
Name:BROOKEMAN, VALERIE A (MD, PHD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:BROOKEMAN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 WILLOW LAWN DR
Mailing Address - Street 2:STE 117
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3421
Mailing Address - Country:US
Mailing Address - Phone:804-288-8102
Mailing Address - Fax:804-282-3744
Practice Address - Street 1:1508 WILLOW LAWN DR
Practice Address - Street 2:STE 117
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3421
Practice Address - Country:US
Practice Address - Phone:804-288-8102
Practice Address - Fax:804-282-3744
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010398272085B0100X, 2085N0700X, 2085N0904X, 2085P0229X, 2085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007210281Medicaid
VA007215509Medicaid
VA007216319Medicaid
VA010248159Medicaid
VA224564OtherANTHEM
VA007200854Medicaid
VA007200692Medicaid
VA007210281Medicaid
VA300034581Medicare PIN