Individual
PAMELA S BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 567-2180
(317) 567-2191
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01040736
IN
207L00000X
Anesthesiology Physician
Primary
01040736A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100473610
—
IN
01
—
264430B89
MEDICARE PTAN
IN
01
—
Q00484438
RAILROAD PTAN
IN
Enumeration date
07/03/2006
Last updated
10/31/2023
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