Provider Demographics
NPI:1801931753
Name:BRAIN, LAWRENCE A (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:A
Last Name:BRAIN
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 1:7910 WOODMONT AVENUE
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:301-654-2255
Mailing Address - Fax:301-718-4945
Practice Address - Street 1:7910 WOODMONT AVE
Practice Address - Street 2:SUITE 1300
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3002
Practice Address - Country:US
Practice Address - Phone:301-654-2255
Practice Address - Fax:301-718-4945
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00198902084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
D18116Medicare UPIN