Individual
MARK P BRYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1705 E BROADWAY, SUITE 100, COLUMBIA, MO 65201-7166
(573) 874-7800
(573) 443-3627
Mailing address
1705 E BROADWAY STE 100, COLUMBIA, MO 65201-7167
(573) 874-7800
(573) 607-3878
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
102993
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11440
GHP
—
01
—
19991
BCBS OF MO
—
05
—
206676603
—
MO
01
—
23324152
BCBS OF KC
—
01
—
2400004
UNITED HEALTHCARE
—
01
—
257403
HEALTHLINK
—
01
—
5132415
AETNA
—
01
—
65201A017
TRICARE
—
01
—
E71404
MERCY HEALTH PLANS
—
Enumeration date
10/03/2005
Last updated
01/31/2025
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