Provider Demographics
NPI:1710448642
Name:SIMES, BRYCE COOLIDGE (DO)
Entity Type:Individual
Prefix:
First Name:BRYCE
Middle Name:COOLIDGE
Last Name:SIMES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 E MARKET ST STE 64B
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-5197
Mailing Address - Country:US
Mailing Address - Phone:540-564-5666
Mailing Address - Fax:757-579-8594
Practice Address - Street 1:1790 E MARKET ST STE 64B
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-5197
Practice Address - Country:US
Practice Address - Phone:540-564-5666
Practice Address - Fax:757-579-8594
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102207294207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program