Provider Demographics
NPI:1770919284
Name:SAWYER, BRIAN DAVID (PT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:DAVID
Last Name:SAWYER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:SAWYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:10 SAINT PATRICKS DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4527
Mailing Address - Country:US
Mailing Address - Phone:301-870-7366
Mailing Address - Fax:301-870-6717
Practice Address - Street 1:10 SAINT PATRICKS DR
Practice Address - Street 2:SUITE 401
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4527
Practice Address - Country:US
Practice Address - Phone:301-870-7366
Practice Address - Fax:301-870-6717
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24707225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist