Individual
MR. BRYAN IGNATIUS FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 UPPER CHESAPEAKE DR, EMERGENCY DEPT, BEL AIR, MD 21014-4324
(443) 643-2000
Mailing address
17 LEWIS CT, NORTH EAST, MD 21901-2244
(410) 287-6977
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0002882
MD
Other
Enumeration date
03/14/2007
Last updated
09/25/2013
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