Provider Demographics
NPI:1477674877
Name:SENG, BRIAN ELLIOT (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ELLIOT
Last Name:SENG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 NORTHSIDE CHEROKEE BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8029
Mailing Address - Country:US
Mailing Address - Phone:770-292-6500
Mailing Address - Fax:770-292-6535
Practice Address - Street 1:470 NORTHSIDE CHEROKEE BLVD STE 160
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8029
Practice Address - Country:US
Practice Address - Phone:770-292-6500
Practice Address - Fax:770-292-6535
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA073059207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5912881Medicaid
NCP01238677OtherMEDICARE RR
OHJO9153082OtherMEDICARE GROUP#
NCP01238677OtherMEDICARE RR
NC5912881Medicaid