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Individual

PAMELA S BRYAN

Active
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Individual

PAMELA S BRYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

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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