Individual
DR. CHARLES L BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
435 AIRPORT BLVD, PENSACOLA, FL 32503-7847
(850) 435-7448
(850) 435-3156
Mailing address
435 AIRPORT BLVD, PENSACOLA, FL 32503-7847
(850) 435-7448
(850) 435-3156
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
08312
MS
207RP1001X
Pulmonary Disease Physician
Primary
ME110790
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124421
—
MS
05
—
003998200
—
FL
05
—
131501
—
AL
05
—
131503
—
AL
05
—
131504
—
AL
01
—
14FJ0
BLUE CROSS BLUE SHIELD
FL
01
—
592-15571
BLUE CROSS BLUE SHIELD
AL
01
—
592-15573
BLUE CROSS BLUE SHIELD
AL
01
—
592-15574
BLUE CROSS BLUE SHIELD
AL
Enumeration date
12/26/2005
Last updated
07/17/2012
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