Provider Demographics
NPI:1700842564
Name:BRYAN, WASHINGTON G B SR (MD)
Entity Type:Individual
Prefix:DR
First Name:WASHINGTON
Middle Name:G B
Last Name:BRYAN
Suffix:SR
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 1:1 ISLAND CLUB CT
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-3372
Mailing Address - Country:US
Mailing Address - Phone:504-392-8107
Mailing Address - Fax:504-891-6353
Practice Address - Street 1:3720 PRYTANIA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3733
Practice Address - Country:US
Practice Address - Phone:504-891-3711
Practice Address - Fax:504-891-6353
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD05226R207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA721020425OtherCOVENTRY
LA721020425OtherUNITED HEALTHCARE
LA1323241Medicaid
LA721020425OtherAETNA
LA1323241Medicaid
LA721020425OtherAETNA