Individual
SHAWNE RENEE BRYANT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
321 EDWIN DR, STE 102, VIRGINIA BEACH, VA 23462-4542
(757) 671-1112
(888) 276-6619
Mailing address
321 EDWIN DR, STE 102, VIRGINIA BEACH, VA 23462-4542
(757) 671-1112
(888) 276-6619
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101038259
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6282431
—
VA
Enumeration date
05/24/2005
Last updated
07/08/2007
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