Provider Demographics
NPI:1851379754
Name:AVIN, BRIAN H (MD)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:H
Last Name:AVIN
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 1:8555 16TH ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2816
Mailing Address - Country:US
Mailing Address - Phone:301-562-7200
Mailing Address - Fax:301-946-4150
Practice Address - Street 1:2730 UNIVERSITY BLVD W
Practice Address - Street 2:SUITE 410
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-1905
Practice Address - Country:US
Practice Address - Phone:301-562-7200
Practice Address - Fax:301-946-4150
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020696174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
B93834Medicare UPIN