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Individual
BRYAN D UPHAM
Active
Individual
BRYAN D UPHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD424533
PA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
MD2007-0577
NM
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
MD424533
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089869
—
NJ
05
—
101460563
—
PA
Enumeration date
07/20/2006
Last updated
09/14/2011
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