Individual
DR. ALVIN B BRYAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1520 N LEG RD, AUGUSTA, GA 30909-4332
(706) 869-3121
(706) 869-3126
Mailing address
1520 N LEG RD, AUGUSTA, GA 30909-4332
(706) 869-3121
(706) 869-3126
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
032138
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100030
BSBS OF GEORGIA
GA
01
—
10040078
AMERIGROUP
GA
05
—
175227350A
—
GA
01
—
52062030
BCBS
GA
05
—
G32138
—
SC
Enumeration date
01/18/2007
Last updated
08/05/2015
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