Healthcare Provider Details

I. General information

NPI: 1336202563
Provider Name (Legal Business Name): BRIAN ADRIAN SHNEIER MB.BCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-5800
US

IV. Provider business mailing address

9613 EAGLE CT
ELLICOTT CITY MD
21042-1757
US

V. Phone/Fax

Practice location:
  • Phone: 301-677-8800
  • Fax: 301-677-8499
Mailing address:
  • Phone: 410-418-4388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD45352
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: