Provider Demographics
NPI:1427180363
Name:KNAB, BRIAN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ROBERT
Last Name:KNAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:424 W BELDEN AVE
Mailing Address - Street 2:APARTMENT #2W
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3829
Mailing Address - Country:US
Mailing Address - Phone:773-472-1987
Mailing Address - Fax:773-834-7340
Practice Address - Street 1:1 ELLIOT WAY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3502
Practice Address - Country:US
Practice Address - Phone:603-663-1800
Practice Address - Fax:603-663-1807
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH134312085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology