Provider Demographics
NPI:1679723597
Name:JEWELL, BRYAN S (MD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:S
Last Name:JEWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4360 CHAMBLEE DUNWOODY RD STE 370
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1081
Mailing Address - Country:US
Mailing Address - Phone:770-393-1988
Mailing Address - Fax:770-399-5726
Practice Address - Street 1:4360 CHAMBLEE DUNWOODY RD STE 370
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341
Practice Address - Country:US
Practice Address - Phone:770-393-1988
Practice Address - Fax:770-399-5726
Is Sole Proprietor?:No
Enumeration Date:2008-09-28
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA067480207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology