Individual
DR. BRIAN G. HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., DACBN, CCN
Contact information
Practice address
9025 CHEVROLET DR, SUITE D, ELLICOTT CITY, MD 21042-4017
(410) 750-2540
(410) 750-2541
Mailing address
9025 CHEVROLET DR, SUITE D, ELLICOTT CITY, MD 21042-4017
(410) 750-2540
(410) 750-2541
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
1467PT
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52122801
MD CAREFIRST LOCAL #
MD
01
—
52122803
MD CAREFIRST LOCAL#TOWSON
MD
01
—
M312HE
MARYLAND CAREFIRST GROUP
MD
01
—
Y921-0001
CAREFIRST
MD
Enumeration date
03/07/2007
Last updated
01/28/2013
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