Provider Demographics
NPI:1467442590
Name:HOWARD, BRIAN KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:KEITH
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1295 HEMBREE RD
Mailing Address - Street 2:BLDG. B, SUITE 200
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5721
Mailing Address - Country:US
Mailing Address - Phone:770-619-9566
Mailing Address - Fax:770-619-9597
Practice Address - Street 1:1295 HEMBREE RD
Practice Address - Street 2:BLDG. B, SUITE 200
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5721
Practice Address - Country:US
Practice Address - Phone:770-619-9566
Practice Address - Fax:770-619-9597
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA45244208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00810235AMedicaid
GAG78042Medicare UPIN
GA24BCBSXMedicare ID - Type Unspecified