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MR. BRIAN MICHAEL BOSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LE

Contact information

Practice address
1621 SULGRAVE AVE, BALTIMORE, MD 21209-3664
(410) 578-0033
Mailing address
707 YORK RD APT 5209, TOWSON, MD 21204-2892
(410) 365-2798

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E01474
MD

Other

Enumeration date
02/22/2021
Last updated
02/22/2021
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