Provider Demographics
NPI:1205145125
Name:BRYANT, ALSEAN R (PHARMD AAHIVP HIVPCP)
Entity type:Individual
Prefix:DR
First Name:ALSEAN
Middle Name:R
Last Name:BRYANT
Suffix:
Gender:M
Credentials:PHARMD AAHIVP HIVPCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4302 SAINT BARNABAS RD STE B
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1842
Mailing Address - Country:US
Mailing Address - Phone:014-231-0713
Mailing Address - Fax:
Practice Address - Street 1:4302 SAINT BARNABAS RD STE B
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1842
Practice Address - Country:US
Practice Address - Phone:301-423-1071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH100000873183500000X
MD24478183500000X, 1835P0018X
VA0202214768183500000X
GARPH030340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist