Individual
DR. MARYANN L BRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2400 17TH ST, COLUMBUS, IN 47201-5351
(812) 376-5144
(812) 376-5431
Mailing address
PO BOX 1329, COLUMBUS, IN 47202-1329
(812) 418-0014
(812) 418-0076
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01036097A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200008140A
—
IN
Enumeration date
10/13/2006
Last updated
12/21/2022
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