Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRYANT T ITTIARA, D.O.
Active Sole ProprietorBRYANT T ITTIARA, D.O. is a Interventional Vascular Surgery healthcare provider located in ALLEN PARK, Michigan. NPI 1871829069 is currently active in the NPPES registry. Verify at CMS.
Interventional Vascular Surgery · ALLEN PARK, MI
Registration Details
- NPI Number
- 1871829069
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 23, 2009 (16.820430189975 yrs)
- Last Updated
- Jan 7, 2019
- Licenses
-
L1593593 (MI)5101017919 (MI)5101017919 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
18707 ECORSE RDALLEN PARK, MI, 481012255Browse MI providers · Browse ZIP 48101
- Phone
- 7346823309
- Fax
- 7346821488
- Primary Specialty
-
Interventional Vascular Surgery
208VP0014X
- Additional Specialty
- Pain Medicine (Anesthesiology)
- Additional Specialty
- Interventional Vascular Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.