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Individual

BRYAN R FINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2978
(202) 884-4177
Mailing address
2300 18TH ST NW APT 304, WASHINGTON, DC 20009-1898
(202) 368-6336

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD33171
DC
2080P0206X
Pediatric Gastroenterology Physician
MD33171
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
034078600
DC
05
434050700
MD
05
5875196
VA
Enumeration date
10/19/2006
Last updated
10/29/2008
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