Individual
BRYANT SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(800) 422-8482
Mailing address
213 S JEFFERSON ST, ROANOKE, VA 24011-1705
(540) 224-5715
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102204394
VA
207RC0000X
Cardiovascular Disease Physician
Primary
0102204394
VA
207RI0011X
Interventional Cardiology Physician
0102204394
VA
Other
Enumeration date
03/28/2014
Last updated
11/16/2022
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