Individual
BRYAN D UPHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 UNIVERSITY OF NEW MEXICO, UNM DEPARTMENT OF EMERGENCY MEDICINE, MSC10 5560, ALBUQUERQUE, NM 87131-0001
(505) 272-5062
(505) 272-6503
Mailing address
933 BRADBURY DR SE STE 2222, ALBUQUERQUE, NM 87106-4375
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD424533
PA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
MD2007-0577
NM
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
MD424533
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089869
—
NJ
05
—
101460563
—
PA
Enumeration date
07/20/2006
Last updated
09/14/2011
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