| Amanda Bryan LLC | |
|
107 Seagrass Station Rd Bluffton SC 29910-9549 | |
| (919) 215-7397 | |
| Not Available |
| Full Name | Amanda Bryan LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 107 Seagrass Station Rd, Bluffton, South Carolina |
| Authorized Official Name and Position | Amanda Bryan (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9192157397 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Bryan LLC 117 Brandywine Rd Savannah GA 31405-5218 Ph: (919) 215-7397 | Amanda Bryan LLC 107 Seagrass Station Rd Bluffton SC 29910-9549 Ph: (919) 215-7397 |
| NPI Number | 1356161079 |
|---|---|
| Provider Enumeration Date | 10/16/2024 |
| Last Update Date | 10/16/2024 |
| Certification Date | 10/16/2024 |
| Medicare PECOS PAC ID | 6507390960 |
|---|---|
| Medicare Enrollment ID | O20241108000208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356161079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Amanda Bryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902338262 PECOS PAC ID: 7012280415 Enrollment ID: I20230418000443 |
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