Individual
KYLE C BRYANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 226-0511
(864) 231-7018
Mailing address
211 S MAIN ST, ANDERSON, SC 29624-1620
(864) 226-0511
(864) 231-7018
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18330
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00693932A
MEDICAID
GA
01
—
300062967
RAIL ROAD MEDICARE
SC
01
—
57-0853635
BLUE CROSS
SC
05
—
T23196
—
SC
Enumeration date
01/12/2007
Last updated
10/17/2007
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