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NPI Code Detail

MEDICARE: BERGINA BRICKHOUSE ISBELL MD

MEDICARE: BERGINA BRICKHOUSE ISBELL 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
12084P0800XPsychiatry Physician4301113664MI
22084P0800XPsychiatry Physician49112MN
32084P0800XPsychiatry PhysicianMD039796DC
42084P0800XPsychiatry PhysicianMD437961PA
52084P0800XPsychiatry PhysicianC150811CA
62084P0800XPsychiatry PhysicianD83609MD

General Provider Information

NPI Number : 1861577553
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERGINA BRICKHOUSE ISBELL MD
Provider Business Mailing Address
First Line : PO BOX 6500
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-6500
Country : US
Telephone Number : 507-533-5441
Fax Number : 844-511-6928
Provider Business Practice Location Address
First Line : 3355 SAINT JOHNS LN STE F
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-2600
Country : US
Telephone Number : 507-533-5433
Fax Number : 844-511-6928
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 12/23/2022

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