Individual
DR. BRYCE DONALD HASLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
39640
IA
207R00000X
Internal Medicine Physician
R-8339
IA
207RG0100X
Gastroenterology Physician
Primary
9016684-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124286133
—
IA
Enumeration date
05/27/2008
Last updated
11/27/2023
Update your record
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