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General NPI Number Information
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NPI Number | 1992933006
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Entity Type | Individual
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Provider Name | BENJAMIN STEVENS BRYNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2009
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 675 N SAINT CLAIR ST STE 19-100
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City | CHICAGO
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State | IL
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Zip | 60611-5969
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Country | US
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Telephone | 312-664-3278
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Fax | 312-695-5774
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Provider Business Mailing Address
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Address Line | 1112 HOSP SOUTH GREEN ZONE DUMC 2834
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City | DURHAM
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State | NC
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Zip | 27710-0001
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Country | US
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Telephone |
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 201900619
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 4301094028
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 201600619
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 036161012
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License Number State | IL
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