Provider Demographics
NPI:1861547119
Name:PARIS, BRIAN R (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:R
Last Name:PARIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46B WEST GUDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4358
Mailing Address - Country:US
Mailing Address - Phone:240-361-2225
Mailing Address - Fax:240-361-0719
Practice Address - Street 1:46B WEST GUDE DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4358
Practice Address - Country:US
Practice Address - Phone:240-361-2225
Practice Address - Fax:240-361-0719
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS2024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU91661Medicare UPIN
MDLY91PAOtherBCBS PPO
MDH874OtherBCBS
MD00B345P79Medicare PIN