Provider Demographics
NPI:1417974304
Name:MARSH, BRYAN JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:JOHN
Last Name:MARSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC, DEPARTMENT OF INFECTIOUS DISEASE
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC, DEPARTMENT OF INFECTIOUS DISEASE
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-6239
Practice Address - Fax:603-650-6110
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH8898207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80002604Medicaid
VT0RE2604Medicaid
F52722Medicare UPIN
NHRE2604Medicare PIN