Provider Demographics
NPI:1891282646
Name:DAHMS, BRYAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:DAVID
Last Name:DAHMS
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 1:12039 E MAPLE SPRINGS WAY
Mailing Address - Street 2:STE A
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-9648
Mailing Address - Country:US
Mailing Address - Phone:907-745-9088
Mailing Address - Fax:907-745-9099
Practice Address - Street 1:12039 E MAPLE SPRINGS WAY
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-9648
Practice Address - Country:US
Practice Address - Phone:907-745-9088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL.0007181207Q00000X
AK179707207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine