Individual
DR. EVERETT BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4241 MAPLE ST, SUITE 200D, DEARBORN, MI 48126-3826
(313) 584-1940
(313) 584-1945
Mailing address
4241 MAPLE ST, SUITE 200D, DEARBORN, MI 48126-3826
(313) 584-1940
(313) 584-1945
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
EB060301
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0806349462
BCBSM
MI
05
—
4364049
—
MI
Enumeration date
01/25/2007
Last updated
05/15/2014
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