Provider Demographics
NPI:1467551473
Name:MACWILLIAMS, BRYAN P (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:P
Last Name:MACWILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 W DESHLER AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-3469
Mailing Address - Country:US
Mailing Address - Phone:614-507-6393
Mailing Address - Fax:
Practice Address - Street 1:1654 UPHAM DR
Practice Address - Street 2:169 MEANS HALL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1250
Practice Address - Country:US
Practice Address - Phone:614-293-8176
Practice Address - Fax:614-293-3124
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.088331207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services