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NPI Code Detail

MEDICARE: BRYAN THOMAS PATTERSON PHD

MEDICARE: BRYAN THOMAS PATTERSON PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist2256NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
161-00143OTHEREVERCARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30385HOTHERNCBCBSNC

General Provider Information

NPI Number : 1316939788
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN THOMAS PATTERSON PHD
Provider Business Mailing Address
First Line : 101 CABARRUS AVE E
Second Line :
City : CONCORD
State : NC
Zip : 28025-3699
Country : US
Telephone Number : 888-849-7379
Fax Number : 855-857-7333
Provider Business Practice Location Address
First Line : 101 CABARRUS AVE E
Second Line :
City : CONCORD
State : NC
Zip : 28025-3699
Country : US
Telephone Number : 888-849-7379
Fax Number : 855-857-7333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 04/08/2020

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