Provider Demographics
NPI:1861454399
Name:BRINSON, GEORGE M (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:BRINSON
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 1:2311 DELANEY RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6012
Mailing Address - Country:US
Mailing Address - Phone:910-762-8754
Mailing Address - Fax:910-762-0778
Practice Address - Street 1:2311 DELANEY RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6012
Practice Address - Country:US
Practice Address - Phone:910-762-8754
Practice Address - Fax:910-762-0778
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200090207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01157OtherBCBS NC
NC6735857OtherCIGNA INDIVIDUAL
NCCD6751OtherRAIL ROAD MEDICARE GROUP
NC8901157Medicaid
NCD3239OtherMEDCOST
NC8901157Medicaid
NY0208Medicare ID - Type UnspecifiedGROUP NUMBER
NC2027612Medicare PIN