NPI 1063626836

Richard James Brouillette, DO

Practitioner Interventional Pain Medicine Physician Waldorf, MD

Practice location

Address: 3460 Old Washington Rd Suite 300, Waldorf, MD 20602-3240
Phone: (301) 645-1523
Fax: (301) 645-6812
Mailing address: 11350 McCormick Rd Executive Plaza 1, Suite 501, Hunt Valley, MD 21031-1002

Registered specialties

Interventional Pain Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208VP0014X Licence H0070918 (MD)

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Registry record

NPI: 1063626836
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 May 2007
Record last updated: 18 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.