Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 001186 | MD |
NPI | 1578717617 |
---|---|
Provider Name | Dr. Rick Bryson |
First Address | Temple Hills, MD 20748-1854 |
Second Address | Temple Hills, MD 20748-1854 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2008 |
Last Update Date | 14/11/2008 |