Provider Demographics
NPI:1700840923
Name:BRYANT, DAVID SHAUN (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SHAUN
Last Name:BRYANT
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 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:120 N 7TH ST STE 200
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1795
Practice Address - Country:US
Practice Address - Phone:717-217-6800
Practice Address - Fax:717-217-6900
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-00124208600000X
PAMD068495L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017470000009Medicaid
PA0017470000010Medicaid
NC5911173Medicaid
PA8455857OtherAETNA HMO
PAP01094191OtherRAILROAD MEDICARE
PA0017470000007Medicaid
PA0017470000008Medicaid
PA7716062OtherAETNA NON HMO
P00309980OtherRAILROAD MEDICARE
PA000544344OtherHIGHMARK BLUE SHIELD
NC15103OtherBCBSNC
099646Medicare PIN
PA000544344OtherHIGHMARK BLUE SHIELD