Provider Demographics
NPI:1285830554
Name:HANEY, BRIAN ROGER (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ROGER
Last Name:HANEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05302-0911
Mailing Address - Country:US
Mailing Address - Phone:207-303-3200
Mailing Address - Fax:207-303-3016
Practice Address - Street 1:105 TOPSHAM FAIR MALL RD UNIT 1
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086
Practice Address - Country:US
Practice Address - Phone:207-303-3300
Practice Address - Fax:207-250-2137
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH20259207RH0003X
ME2047207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology