Individual
DAVID BRINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1070
Mailing address
PO BOX 20238, CANTON, OH 44701-0238
(866) 684-1492
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35074325O
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210671
BC/BS INDIVIDUAL PIN NO
OH
05
—
2072653
—
OH
Enumeration date
07/22/2005
Last updated
07/19/2007
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