Provider Demographics
NPI:1174579320
Name:BRULL & HONIG MDPA
Entity type:Organization
Organization Name:BRULL & HONIG MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:HONIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-581-1500
Mailing Address - Street 1:23 CROSSROADS DR
Mailing Address - Street 2:SUITE #310
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5420
Mailing Address - Country:US
Mailing Address - Phone:410-581-1500
Mailing Address - Fax:410-581-0577
Practice Address - Street 1:23 CROSSROADS DR
Practice Address - Street 2:SUITE #310
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5420
Practice Address - Country:US
Practice Address - Phone:410-581-1500
Practice Address - Fax:410-581-0577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK892Medicare ID - Type Unspecified
MD0688650001Medicare NSC