Allen Wayne Bryan Jr., M.D., PH.D.

Primary specialty

Clinical Pathology PhysicianTaxonomy code 207ZC0006X

License

34658 Issued in AL

Practice address

330 Brookline Ave
Department of Pathology
Boston, MA 02215-5400

Phone

(617) 667-4344

Fax

(617) 667-7120

NPI assigned

Apr 12, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1417214701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-4344",
            "fax_number": "617-667-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-4344",
            "fax_number": "617-667-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "ALLEN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "AL",
            "license": "34658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asher Pincus Bruskin, MSW
• Ana Brussa, OT
• Roland R Brusseau, MD
• Robert M Brustowicz, MD
• Lynn Bry, MD
• Elisabeth Lawrence Bryan, LICSW
• Justin Patrick Bryan, PA
• Lia Michele Bryan
• Oceana Bryan
• Allison S. Bryant Mantha, M.D., M.P.H.

• Clinical Pathology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Pathology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.