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1346292208

NPI Code Detail

MEDICARE: JOHN A BRYAN MD

MEDICARE: JOHN A 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	9899	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346292208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN A BRYAN MD

Provider Business Mailing Address
First Line	:	1 ELLIOT WAY
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03103-3599
Country	:	US
Telephone Number	:	603-663-2583
Fax Number	:	603-663-4120

Provider Business Practice Location Address
First Line	:	1 ELLIOT WAY
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03103-3599
Country	:	US
Telephone Number	:	603-663-2583
Fax Number	:	603-663-4120

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	12/16/2010

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Directions to “ JOHN A BRYAN MD” Practice Location

Language	Start Address	Practice Location

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