Ittiara, Bryant T

Ittiara, Bryant T is an sole proprietor health care provider with primary practice located at 18707 Ecorse Rd , Allen Park MI 48101-2255. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Ittiara, Bryant T can be contacted via phone (734) 682-3309.

Contact Information

Primary practice address
18707 Ecorse Rd Allen Park MI 48101-2255
Phone: (734) 682-3309
Fax: (734) 682-1488
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X L1593593 Michigan
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 5101017919 Michigan
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 5101017919 Michigan

Profile Details

NPI number 1871829069
LBN Legal business name Ittiara, Bryant T
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 23rd, 2009
Last updated Jan 7th, 2019 - about 5 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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