Provider Demographics
NPI:1174039903
Name:SLAYMAN, BRYAN (RD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:SLAYMAN
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 PARK ST SE STE 300
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4653
Mailing Address - Country:US
Mailing Address - Phone:703-255-9100
Mailing Address - Fax:
Practice Address - Street 1:115 PARK ST SE STE 300
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4653
Practice Address - Country:US
Practice Address - Phone:703-255-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
1109216OtherCOMMISSION ON DIETETIC REGISTRATION