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General NPI Number Information
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NPI Number | 1174794507
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Entity Type | Organization
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Legal Business Name | BRIAN S. KRESSIN
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 15300 SPENCERVILLE CT SUITE 101
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1653
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Country | US
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Telephone | 301-421-4286
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Fax |
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Provider Business Mailing Address
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Address Line | 15300 SPENCERVILLE CT SUITE 101
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1653
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Country | US
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Telephone | 301-421-4286
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | BRIAN SAMUEL KRESSIN
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Credential | DPM
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Telephone | 301-384-2629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 00889
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License Number State | MD
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