Provider Demographics
NPI:1790788370
Name:BRIAN, MARY B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:B
Last Name:BRIAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8289 DIAMOND BACK COVE RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-5035
Mailing Address - Country:US
Mailing Address - Phone:410-310-1827
Mailing Address - Fax:410-820-8405
Practice Address - Street 1:8289 DIAMOND BACK COVE RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-5035
Practice Address - Country:US
Practice Address - Phone:410-310-1827
Practice Address - Fax:410-820-8405
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2019-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0043040207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD446541500Medicaid
MD446541500Medicaid
MDH415072LMedicare PIN