Provider Demographics
NPI:1497732432
Name:SYGIEL, BRIAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:R
Last Name:SYGIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:27555 FARMINGTON RD
Mailing Address - Street 2:STE 130
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3376
Mailing Address - Country:US
Mailing Address - Phone:248-855-1020
Mailing Address - Fax:248-855-2639
Practice Address - Street 1:27555 FARMINGTON RD
Practice Address - Street 2:STE 130
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3376
Practice Address - Country:US
Practice Address - Phone:248-855-1020
Practice Address - Fax:248-855-2639
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301068575207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H19131Medicare UPIN
ON40420Medicare ID - Type Unspecified