Provider Demographics
NPI:1740395029
Name:BREZINSKI, DAMIAN (MD)
Entity Type:Individual
Prefix:
First Name:DAMIAN
Middle Name:
Last Name:BREZINSKI
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 1:1328 LAKE PARK BLVD N
Mailing Address - Street 2:STE 103
Mailing Address - City:CAROLINA BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28428-3906
Mailing Address - Country:US
Mailing Address - Phone:910-341-3300
Mailing Address - Fax:910-341-3321
Practice Address - Street 1:1328 LAKE PARK BLVD N
Practice Address - Street 2:STE 103
Practice Address - City:CAROLINA BEACH
Practice Address - State:NC
Practice Address - Zip Code:28428-3906
Practice Address - Country:US
Practice Address - Phone:910-341-3301
Practice Address - Fax:910-341-7946
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35595207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC18195OtherBCBS NC
NC8918195Medicaid
NC110123231OtherRAILROAD MEDICARE
NC18195OtherBCBS NC
NCF46691Medicare UPIN