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General NPI Number Information
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NPI Number | 1184249823
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Entity Type | Individual
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Provider Name | JAMESHA SADA LEWIS BRYANT DO
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Gender | Female
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 621 EMANCIPATION HWY
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4567
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Country | US
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Telephone | 540-372-2028
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Fax | 540-372-6541
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Provider Business Mailing Address
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Address Line | 621 EMANCIPATION HWY
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4567
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Country | US
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Telephone | 540-372-2028
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Fax | 540-372-6541
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 0116034239
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License Number State | VA
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