Bryant T Ittiara, DO is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in Allen Park, Michigan. His current practice location is
18707 Ecorse Rd, Allen Park, Michigan. You can reach out to his office (for appointments etc.) via phone at
(734) 682-3309.
Bryant T Ittiara is licensed to practice in Michigan (license number 5101017919) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1871829069.
Physician's Profile
| Full Name | Bryant T Ittiara |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 18707 Ecorse Rd, Allen Park, Michigan |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Bryant T Ittiara attended and graduated from in
NPI Data:
- NPI Number: 1871829069
- Provider Enumeration Date: 10/23/2009
- Last Update Date: 01/07/2019
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Bryant T Ittiara such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1871829069 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207L00000X | Anesthesiology | L1593593 (Michigan) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | 5101017919 (Michigan) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 5101017919 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bryant T Ittiara is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Bryant T Ittiara, DO
416 James Cir,
Royal Oak, MI 48067-4545
Ph: (734) 604-0017 | Bryant T Ittiara, DO
18707 Ecorse Rd,
Allen Park, MI 48101-2255
Ph: (734) 682-3309 |
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