Healthcare Provider Details

I. General information

NPI: 1235100116
Provider Name (Legal Business Name): JOSEPH OSLER BRICE D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 MOUNTAIN RD STE A
PASADENA MD
21122-2015
US

IV. Provider business mailing address

3021 MOUNTAIN RD STE A
PASADENA MD
21122-2015
US

V. Phone/Fax

Practice location:
  • Phone: 410-437-9366
  • Fax: 410-437-8107
Mailing address:
  • Phone: 410-437-9366
  • Fax: 410-437-8107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number00969
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number00969
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number00969
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: