Provider Demographics
NPI:1104421197
Name:AMY, BRIAN WINFORD (MD,MPH,FACS,FACPM)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:WINFORD
Last Name:AMY
Suffix:
Gender:M
Credentials:MD,MPH,FACS,FACPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 N CAPITOL ST NE STE 5
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-5686
Mailing Address - Country:US
Mailing Address - Phone:202-631-0766
Mailing Address - Fax:
Practice Address - Street 1:899 N CAPITOL ST NE STE 5
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5686
Practice Address - Country:US
Practice Address - Phone:202-631-0766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0371422083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine