Provider Demographics
NPI:1235100116
Name:BRICE, JOSEPH OSLER (DPM)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:OSLER
Last Name:BRICE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 MOUNTAIN RD STE A
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-2015
Mailing Address - Country:US
Mailing Address - Phone:410-437-9366
Mailing Address - Fax:410-437-8107
Practice Address - Street 1:3021 MOUNTAIN RD STE A
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-2015
Practice Address - Country:US
Practice Address - Phone:410-437-9366
Practice Address - Fax:410-437-8107
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00969213E00000X, 213ES0131X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD69219OtherPRINCIPAL HEALTH CARE -DE
MDKBQ4COOtherBLUE CROSS BLUE SHIELD
MD236264OtherUNITED HEALTHCARE
MD73174OtherCOVENTRY HEALTH CARE - DE
DCW219-0002OtherBLUE CROSS BLUE SHIELD
MD214881OtherM.A.M.S.I.
MD43521-8100Medicaid
MD12565OtherPRIORITY PARTNERS
DCW219-0002OtherBLUE SHIELD FEP PROGRAM
MD69219OtherPRINCIPAL HEALTH CARE -DE