Provider Demographics
NPI:1447647938
Name:BRYANT, ELIZABETH BARROWS (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BARROWS
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:CLARK
Other - Last Name:BARROWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2300 HAGGERTY RD
Mailing Address - Street 2:STE 2070
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2190
Mailing Address - Country:US
Mailing Address - Phone:248-926-2020
Mailing Address - Fax:248-926-9020
Practice Address - Street 1:3990 JOHN R ST
Practice Address - Street 2:7-BRUSH N, MAIL BOX 165
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2018
Practice Address - Country:US
Practice Address - Phone:313-993-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301500239207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program