Individual
BRYAN T. AMBRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2002 MEDICAL PKWY, SUITE #230, ANNAPOLIS, MD 21401-3282
(410) 266-3900
(410) 266-9245
Mailing address
2002 MEDICAL PKWY, SUITE #230, ANNAPOLIS, MD 21401-3282
(410) 266-3900
(410) 266-9245
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
D0064743
MD
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
D0064743
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102864
GEISINGER
MD
01
—
2154511
MAMSI
MD
01
—
2448951
UNITED NATIONAL
MD
01
—
313988
AMERIGROUP
MD
Enumeration date
11/02/2006
Last updated
09/15/2016
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