Healthcare Provider Details
I. General information
NPI: 1073807681
Provider Name (Legal Business Name): BRIAN K. DO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/01/2011
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5454 WISCONSIN AVE STE 650
CHEVY CHASE MD
20815-6956
US
IV. Provider business mailing address
7501 GREENWAY CENTER DR # 300
GREENBELT MD
20770-3514
US
V. Phone/Fax
- Phone: 301-656-8100
- Fax:
- Phone: 301-474-4679
- Fax: 301-474-7182
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 0101265033 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207WX0108X |
| Taxonomy | Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician |
| License Number | D085870 |
| License Number State | MD |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207WX0108X |
| Taxonomy | Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician |
| License Number | 0101265033 |
| License Number State | VA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207WX0107X |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| License Number | D085870 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: