BRIAN NEAL GLICK (NPI# 1790792539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790792539 |
| Entity Type | Individual |
| Full Name | BRIAN NEAL GLICK |
| Credential | MD |
| Practice Address |
3022 Williams Dr Ste 300 Fairfax VA 22031-4600 |
| Mailing Address |
611 S Carlin Springs Rd Suite 405 Arlington VA 22204-1087 |
| Practice Telephone | 7035739800 |
| Practice Fax Number | 7035732959 |
| Mailing Telephone | 7036712490 |
| Mailing Fax Number | 7038207207 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2017-08-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
0101049247 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 6061001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336270081 | Brian H Glick | Physician Assistant | 1101 Nott St, Ellis Medicine, Schenectady, NY 12308-2425 | 2007-03-07 |
| Street Address |
3022 WILLIAMS DR STE 300 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740253020 | Peter Lee Jr. | Pediatrics | 3022 Williams Dr, Suite 301, Fairfax, VA 22031-4600 | 2006-02-08 |
| 1356731822 | Sheryl Kongstvedt | Psychologist | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2015-02-04 |
| 1316283914 | Christiane Gallen Davenport | Nurse Practitioner | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2012-12-31 |
| 1972860807 | Hematology Oncology Care of Northern Virginia PC | Internal Medicine | 3022 Williams Dr, Suite 100, Fairfax, VA 22031-4600 | 2012-04-17 |
| 1346526191 | Kathleen Rodgers | Dietitian, Registered | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2011-10-25 |
| 1831410497 | Thania Violeta Lamirand | Emergency Medicine | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2010-06-17 |
| 1326279043 | Bhavika Amin | Nurse Practitioner | 3022 Williams Dr, #300, Fairfax, VA 22031-4600 | 2009-07-29 |
| 1538308978 | Candice M. Driscoll | Physician Assistant | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2009-02-09 |
| 1285884007 | Min Jin Jung Detrick | Physician Assistant | 3022 Williams Dr, 300, Fairfax, VA 22031-4600 | 2008-09-29 |
| 1982871588 | Seyeda Masomeh Abedi | Internal Medicine | 3022 Williams Dr, Suite 300, Fairfax, VA 22031-4600 | 2008-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639338551 | Behnam Nonahal Tehrani | Internal Medicine | 8081 Innovation Park Dr # 700, Fairfax, VA 22031-4867 | 2008-06-05 |
| 1851434252 | Virginia Cardiology, PC | Internal Medicine | 3020 Hamaker Ct Ste 500, Fairfax, VA 22031-2220 | 2007-02-15 |
| 1164569687 | Kelly Charrise Epps-anderson | Internal Medicine | 8505 Arlington Blvd Ste 200, Fairfax, VA 22031 | 2007-01-31 |
| 1700940426 | Steven F Berman | Internal Medicine | 12103 Green Ledge Ct, Apartment 301, Fairfax, VA 22033-2548 | 2006-12-20 |
| 1265543342 | Anne E Summers | Internal Medicine | 3023 Hamaker Court, #100, Fairfax, VA 22031 | 2006-08-31 |
| 1831171800 | Jason Mark Rashkin | Internal Medicine | 12011 Lee Jackson Memorial Hwy, Fairfax, VA 22033-3310 | 2005-11-16 |
| 1467459404 | F. Joseph Hallal | Internal Medicine | 8505 Arlington Blvd, Suite 200, Fairfax, VA 22031-4621 | 2005-07-06 |
| 1285638528 | Stuart E. Sheifer | Internal Medicine | 3580 Joseph Siewick Dr Ste 305, Fairfax, VA 22033-1764 | 2005-06-01 |
| 1477971109 | David James Kopin | Internal Medicine | 8081 Innovation Park Dr # 700, Fairfax, VA 22031-4867 | 2014-03-31 |
| 1619291531 | Casey Raymond Benton | Internal Medicine | 3580 Joseph Siewick Dr Ste 305, Fairfax, VA 22033-1764 | 2010-03-22 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.