Provider Demographics
NPI:1851452452
Name:YOUNG, BRYAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:J
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:850 HARVARD WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2055
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:6570 S MCCARRAN BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6112
Practice Address - Country:US
Practice Address - Phone:775-982-8256
Practice Address - Fax:775-982-8251
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9545207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11042299OtherCAQH
NVV35094Medicare PIN
NVCI657ZMedicare PIN
NVH26728Medicare UPIN