Individual
BRYAN W CORWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
873
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38624
BCBS OF NEBRASKA
NE
Enumeration date
07/31/2006
Last updated
07/08/2007
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