Individual
BRYANT HALIBURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 IRVING ST NW, WASHINGTON, DC 20010-2976
(301) 946-5100
(301) 929-0348
Mailing address
11510 GEORGIA AVE, SUITE 206, WHEATON, MD 20902-1925
(301) 946-5100
(301) 929-0348
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
58606
GA
207L00000X
Anesthesiology Physician
MD034253
DC
207L00000X
Anesthesiology Physician
MD428012
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002045100
—
MD
05
—
010119600
—
VA
01
—
0157
CAREFIRST BCBS
DC
05
—
036101900
—
DC
01
—
144796
ANTHEM BCBS
VA
01
—
2126003
MAMSI
DC
01
—
243937
KAISER
DC
01
—
3627348
AETNA HMO
DC
01
—
674292
NCPPO
DC
01
—
7262589
AETNA NONHMO
DC
Enumeration date
08/31/2006
Last updated
08/11/2023
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