Individual
DR. BRYCE CHANDLER BIBERSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
Mailing address
PO BOX 208, FORT WAYNE, IN 46801-0208
(260) 436-8686
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01093785A
IN
207X00000X
Orthopaedic Surgery Physician
4301115508
MI
207X00000X
Orthopaedic Surgery Physician
67511
TN
Other
Enumeration date
06/22/2018
Last updated
09/19/2024
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