1336202563 NPI number — DR. BRIAN ADRIAN SHNEIER MB.BCH

Table of content: DR. BRIAN ADRIAN SHNEIER MB.BCH (NPI 1336202563)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336202563 NPI number — DR. BRIAN ADRIAN SHNEIER MB.BCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHNEIER
Provider First Name:
BRIAN
Provider Middle Name:
ADRIAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MB.BCH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336202563
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9613 EAGLE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLICOTT CITY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21042-1757
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-418-4388
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2480 LLEWELLYN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT MEADE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20755-5800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-677-8800
Provider Business Practice Location Address Fax Number:
301-677-8499
Provider Enumeration Date:
12/19/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  D45352 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)