Provider Demographics
NPI:1255433017
Name:BRIGHAM, MARIE HINMAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:HINMAN
Last Name:BRIGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:107 RIDGELY AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401
Mailing Address - Country:US
Mailing Address - Phone:410-268-6464
Mailing Address - Fax:410-268-1109
Practice Address - Street 1:107 RIDGELY AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:410-268-6464
Practice Address - Fax:410-268-1109
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD51673207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD173RMedicare ID - Type Unspecified
F06308Medicare UPIN