Individual
BRENT C. BIRELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 YORK RD, BUILDING A, SUITE 100, LUTHERVILLE, MD 21093-6016
(410) 828-9570
(410) 583-9120
Mailing address
1300 YORK RD, BUILDING A, SUITE 100, LUTHERVILLE, MD 21093-6016
(410) 828-9570
(410) 583-9120
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
D0036028
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA3208 240007648
RAILROAD MEDICARE
GA
01
—
E681 0001
CAREFIRST
DC
Enumeration date
06/29/2006
Last updated
03/24/2008
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