Organization
BRIAN P, BACH D.P.M.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN PHILLIP BACH D.P.M. (PHYSICIAN)
(301) 868-0087
Entity
Organization
Contact information
Practice address
9015 WOODYARD RD, SUITE 211, CLINTON, MD 20735-4209
(301) 868-0087
Mailing address
9015 WOODYARD RD, SUITE 211, CLINTON, MD 20735-4209
(301) 868-0087
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380598100
—
MD
Enumeration date
01/31/2008
Last updated
05/01/2008
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