Bryan, Daniel Justin

Bryan, Daniel Justin is an individual health care provider with primary practice located at 2311 Lewisville Clemmons Rd , Clemmons NC 27012-8905. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Bryan, Daniel Justin can be contacted via phone (336) 716-2255.

Contact Information

Primary practice address
2311 Lewisville Clemmons Rd Clemmons NC 27012-8905
Phone: (336) 716-2255
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0010-02688 North Carolina

Profile Details

NPI number 1710281035
LBN Legal business name Bryan, Daniel Justin
Credentials PA-C, MPAS
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2010
Last updated Apr 29th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710281035 NPPES
North Carolina MEDICAID 8102835

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