Provider Demographics
NPI:1437281821
Name:BREYER, RICHARD J III (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:BREYER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 N GREENE ST
Mailing Address - Street 2:IMAGING SERVICES #114
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1524
Mailing Address - Country:US
Mailing Address - Phone:410-605-7175
Mailing Address - Fax:410-605-7925
Practice Address - Street 1:10 N GREENE ST
Practice Address - Street 2:IMAGING SERVICE #114
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7175
Practice Address - Fax:410-605-7925
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN06064353A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology