Individual
DR. CHACEY BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3205 RANDALL PKWY STE 105, WILMINGTON, NC 28403-2565
(910) 742-9243
Mailing address
105 FRANKLIN SQUARE WAY STE A, EASLEY, SC 29642-3715
(864) 442-4110
(864) 442-4126
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
87072
SC
208D00000X
General Practice Physician
2024-01387
NC
208D00000X
General Practice Physician
296938-1
NY
208D00000X
General Practice Physician
Primary
87072
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870720
—
SC
Enumeration date
07/25/2016
Last updated
10/30/2024
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