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Individual

BRIAN NEAL GLICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3022 WILLIAMS DR, STE 300, FAIRFAX, VA 22031-4600
(703) 573-9800
(703) 573-2959
Mailing address
611 S CARLIN SPRINGS RD, SUITE 405, ARLINGTON, VA 22204-1087
(703) 671-2490
(703) 820-7207

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101049247
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6061001
VA
Enumeration date
08/02/2006
Last updated
08/18/2017
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