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NPI Code Detail

MEDICARE: DAVID BRINE MD

MEDICARE: DAVID BRINE 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
12085R0202XDiagnostic Radiology Physician35074325OOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000210671OTHEROHBC/BS INDIVIDUAL PIN NO
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902806748
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID BRINE MD
Provider Business Mailing Address
First Line : PO BOX 20238
Second Line :
City : CANTON
State : OH
Zip : 44701-0238
Country : US
Telephone Number : 866-684-1492
Fax Number :
Provider Business Practice Location Address
First Line : 1320 MERCY DR NW
Second Line :
City : CANTON
State : OH
Zip : 44708-2614
Country : US
Telephone Number : 330-489-1070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 07/19/2007

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Directions to “ DAVID BRINE MD” Practice Location

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