Individual
DR. MICHAEL CONRAD BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5310 W THUNDERBIRD RD STE 308, GLENDALE, AZ 85306-4710
(623) 412-2229
(602) 314-5843
Mailing address
22 WATERVILLE RD, AVON, CT 06001-2066
(860) 678-3402
(844) 364-3181
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
37126
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
411665
MEDICAID
AZ
Enumeration date
07/26/2007
Last updated
12/08/2021
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