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NPI Code Detail

MEDICARE: BRYCE BOBB DO

MEDICARE: BRYCE BOBB DO
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician39556NH

General Provider Information

NPI Number : 1457095762
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYCE BOBB DO
Provider Business Mailing Address
First Line : 333 BORTHWICK AVE
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-7128
Country : US
Telephone Number : 317-604-7170
Fax Number :
Provider Business Practice Location Address
First Line : 333 BORTHWICK AVE
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-7128
Country : US
Telephone Number : 317-604-7170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2022
Last Update Date : 06/24/2026

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