Provider Demographics
NPI:1144204645
Name:BRYANT, DENISE ABSHER (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:ABSHER
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 DOCTOR STREET
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NC
Mailing Address - Zip Code:28675-9247
Mailing Address - Country:US
Mailing Address - Phone:336-372-5606
Mailing Address - Fax:336-372-6211
Practice Address - Street 1:214 DOCTOR STREET
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675-9247
Practice Address - Country:US
Practice Address - Phone:336-372-5606
Practice Address - Fax:336-372-6211
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100112207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1144204645Medicaid
NC8579815OtherCIGNA HEALTHCARE
NC129XFOtherBLUE CROSS BLUE SHELD OF NORTH CAROLINA
NC89129XFMedicaid
VA238680OtherBLUE CROSS ANTHEM OF VIRGINIA
NC192454OtherMEDCOST
NC42366OtherPARTNERS
NC192454OtherMEDCOST