Individual
DR. BRYAN ANTHONY MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8316 ARLINGTON BLVD, SUITE 300, FAIRFAX, VA 22031-5207
(703) 573-7600
(703) 560-3808
Mailing address
3801 UNIVERSITY DR, # 200, FAIRFAX, VA 22030-2503
(703) 573-7600
(703) 560-3808
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
0101055139
VA
207YX0901X
Otology & Neurotology Physician
Primary
0101055139
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010
CAREFIRST ID#
—
05
—
006501362
—
VA
01
—
0101055139
STATE LICENSE #
VA
Enumeration date
04/20/2006
Last updated
12/21/2018
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