Basic Information
Provider Information
NPI: 1538502349
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRILLHART
FirstName: HEATHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 8110 MAPLE LAWN BLVD STE 235
Address2:  
City: FULTON
State: MD
PostalCode: 207592694
CountryCode: US
TelephoneNumber: 3013408339
FaxNumber: 3013409027
Practice Location
Address1: 10801 LOCKWOOD DR STE 320
Address2:  
City: SILVER SPRING
State: MD
PostalCode: 209011559
CountryCode: US
TelephoneNumber: 3016813400
FaxNumber: 3016817982
Other Information
ProviderEnumerationDate: 04/10/2013
LastUpdateDate: 09/27/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VX0000XD0083739MDY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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