Individual
DR. MICHAEL GRANT BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4488 S PECOS RD, LAS VEGAS, NV 89121-5030
(702) 436-1001
(702) 436-7999
Mailing address
PO BOX 12060, LAS VEGAS, NV 89112-0060
(702) 360-2100
(909) 557-1924
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
11335
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01115811
RR MEDICARE
NV
Enumeration date
09/02/2006
Last updated
01/31/2013
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