Individual
BRYAN R. NEUWIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
261 18TH STREET CIR SE, HICKORY, NC 28602-1362
(828) 327-7867
(828) 327-6299
Mailing address
261 18TH STREET CIR SE, HICKORY, NC 28602-1362
(828) 327-7867
(828) 327-6299
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
36121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2339122
MEDICARE GROUP NUMBER
NC
05
—
8996361
—
NC
Enumeration date
06/13/2005
Last updated
12/19/2007
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