MEDICARE: DR. JAMES BERTRAND O'BRYAN MD

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
1	207RH0003X	Hematology & Oncology Physician	LL92220	SC

General Provider Information

NPI Number	:	1023696176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES BERTRAND O'BRYAN MD

Provider Business Mailing Address
First Line	:	3800 RESERVOIR RD NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007-2113
Country	:	US
Telephone Number	:	202-444-8168
Fax Number	:	877-303-1460

Provider Business Practice Location Address
First Line	:	171 ASHLEY AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-2113
Country	:	US
Telephone Number	:	843-792-1414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2021
Last Update Date	:	06/18/2024

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