NPI Profile for Dr JUSTIN R BRYANT in FORT WAYNE, IN.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Plastic and Reconstructive Surgery |
2086S0122X | 02 | Physician/General Surgery | |
Plastic Surgery |
208200000X | 02 | Physician/General Surgery |
| NPI # | 1427363449 |
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| Status | Active | |
| Credentials | DO, MBA | |
| Entity | Individual | |
| Enumeration date | 08/13/2010 | |
| Last updated | 05/22/2025 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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JUSTIN R BRYANT
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