Provider Demographics
NPI:1871120329
Name:ADAM, BRYAN JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:JAMES
Last Name:ADAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10105 BANBURRY CROSS DR STE 170
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-6647
Mailing Address - Country:US
Mailing Address - Phone:702-765-5437
Mailing Address - Fax:702-240-7268
Practice Address - Street 1:10105 BANBURRY CROSS DR STE 170
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-6647
Practice Address - Country:US
Practice Address - Phone:702-765-5437
Practice Address - Fax:702-240-7268
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVDO3408208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics