Provider Demographics
NPI:1568651990
Name:HARMYCH, BRIAN MATHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:MATHEW
Last Name:HARMYCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 BARNWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:41017
Mailing Address - Country:US
Mailing Address - Phone:859-331-9600
Mailing Address - Fax:859-331-5831
Practice Address - Street 1:133 BARNWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:OH
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-331-9600
Practice Address - Fax:859-331-5831
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57013974207Y00000X
KY45269207YS0123X
OH35.098399207YS0123X
CO51087207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology