Provider Demographics
NPI:1679212864
Name:BRILLHART, MADELINE ANN (OD)
Entity type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:ANN
Last Name:BRILLHART
Suffix:
Gender:
Credentials:OD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1729 NEW HANOVER MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5345
Mailing Address - Country:US
Mailing Address - Phone:910-763-3601
Mailing Address - Fax:910-763-4608
Practice Address - Street 1:1729 NEW HANOVER MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5345
Practice Address - Country:US
Practice Address - Phone:910-763-3601
Practice Address - Fax:910-763-4608
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2745152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist