Individual
DR. BRYAN E. MCDONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 W UNIVERSITY AVE STE 300, MUNCIE, IN 47303-3432
(765) 747-3883
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01077245A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
010122217
VA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01077245A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
4301089061
MI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD061574L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780682781
—
VA
Enumeration date
07/13/2005
Last updated
10/10/2022
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