Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35082029 | OH |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 35-082029 | OH |
NPI | 1497798375 |
---|---|
Provider Name | Bryan T Chambers |
First Address | Columbus, OH 43213-4441 |
Second Address | Columbus, OH 43213-4441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 24/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000517387 | ANTHEM (01) | OH |
2375906 | (05) | OH |
7441818 | AETNA (01) | OH |
H77859 | (02) | OH |