Individual
MARCUS ALAN BRYNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 RAMSEY AVE, GRANTS PASS, OR 97527-5554
(541) 472-7140
Mailing address
PO BOX 1750, GRANTS PASS, OR 97528-0148
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A78883
CA
2085R0204X
Vascular & Interventional Radiology Physician
A78883
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213105
—
OR
Enumeration date
06/26/2006
Last updated
10/04/2007
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