Healthcare Provider Details

I. General information

NPI: 1073503918
Provider Name (Legal Business Name): STEVEN HOWARD BRICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2005
Last Update Date: 08/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4061 POWDER MILL RD SUITE 210
CALVERTON MD
20705-3149
US

IV. Provider business mailing address

4061 POWDER MILL RD SUITE 210
CALVERTON MD
20705-3149
US

V. Phone/Fax

Practice location:
  • Phone: 202-669-8501
  • Fax: 240-846-4190
Mailing address:
  • Phone: 202-669-8501
  • Fax: 240-846-4190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD14965
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD37411
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: