Provider Demographics
NPI:1376544304
Name:DRAGAN, BRIAN KEITH (DCM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:KEITH
Last Name:DRAGAN
Suffix:
Gender:M
Credentials:DCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 FOREST VIEW RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2818
Mailing Address - Country:US
Mailing Address - Phone:410-766-1444
Mailing Address - Fax:410-768-5703
Practice Address - Street 1:7575 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-8951
Practice Address - Country:US
Practice Address - Phone:410-766-1444
Practice Address - Fax:410-768-5703
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD52167002OtherBSMD
357TMedicare ID - Type Unspecified
MD52167002OtherBSMD