MEDICARE: CHRISTIAN MICHAEL BRIERY 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	207VM0101X	Maternal & Fetal Medicine Physician	MD40768	TN

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	:	1912968843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN MICHAEL BRIERY MD

Provider Business Mailing Address
First Line	:	1202 LOUISIANA AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71101-3910
Country	:	US
Telephone Number	:	318-212-8951
Fax Number	:	318-212-6752

Provider Business Practice Location Address
First Line	:	2508 BERT KOUNS INDUSTRIAL LOOP STE 210
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71118-3175
Country	:	US
Telephone Number	:	318-212-5860
Fax Number	:	318-212-5865

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

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	06/18/2021

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