Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 10071 | SC |
NPI | 1376510255 |
---|---|
Provider Name | Dr. Martha Carolyn Bryan |
First Address | Charleston, SC 29417-0309 |
Second Address | Charleston, SC 29401-1113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 23/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100713 | (05) | SC |
C60950 | (02) |