Individual
BRIAN F ANTONUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-6070
(410) 955-0833
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
(410) 500-5266
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
015066
NY
363AS0400X
Surgical Physician Assistant
Primary
C06717
MD
Other
Enumeration date
09/06/2011
Last updated
08/08/2024
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