Healthcare Provider Details

I. General information

NPI: 1497798375
Provider Name (Legal Business Name): BRYAN T CHAMBERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 POLARIS PKWY
WESTERVILLE OH
43082-7971
US

IV. Provider business mailing address

340 POLARIS PKWY
WESTERVILLE OH
43082-7971
US

V. Phone/Fax

Practice location:
  • Phone: 614-839-2300
  • Fax: 614-839-2301
Mailing address:
  • Phone: 614-839-2300
  • Fax: 614-839-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number35-082029
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35082029
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: