Individual
BRYAN N. BAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13347 WARWICK BLVD, NEWPORT NEWS, VA 23602-5601
(757) 877-0214
(757) 875-0524
Mailing address
860 OMNI BLVD STE 101, NEWPORT NEWS, VA 23606-4430
(757) 232-8777
(757) 232-8875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101043474
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102080
UNITED HEALTHCARE PROV. #
VA
01
—
080105932
RAILROAD MEDICARE
VA
01
—
233398
MAMSI PROVIDER NUMBER
VA
01
—
250460
ANTHEM PROVIDER NUMBER
VA
05
—
5623014
—
VA
Enumeration date
05/23/2005
Last updated
03/19/2021
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