MEDICARE: DR. BRIAN EGAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	D33736	MD
2	207W00000X	Ophthalmology Physician	0101039522	VA
3	207W00000X	Ophthalmology Physician	MD13798	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164598470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN EGAN MD

Provider Business Mailing Address
First Line	:	6845 ELM STREET
Second Line	:	SUITE 611
City	:	MCLEAN
State	:	VA
Zip	:	22101-3822
Country	:	US
Telephone Number	:	703-956-6880
Fax Number	:	703-893-7336

Provider Business Practice Location Address
First Line	:	6845 ELM STREET
Second Line	:	SUITE 611
City	:	MCLEAN
State	:	VA
Zip	:	22101-3822
Country	:	US
Telephone Number	:	703-956-6880
Fax Number	:	703-893-7336

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	09/05/2008

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Directions to “ DR. BRIAN EGAN MD” Practice Location

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