Provider Demographics
NPI:1235424144
Name:BEHM, BRITTANY (DO)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BEHM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8185 WASHINGTON ST STE 4
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-4577
Practice Address - Country:US
Practice Address - Phone:440-708-1580
Practice Address - Fax:440-708-1585
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-02355207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNC2123Medicaid
NC1235424144Medicaid
NCNCJ681AMedicare PIN