Basic Information
| Provider Information | |||||||||
| NPI: | 1073884508 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BIANCA BRYANT-GREENWOOD MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 25668 | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968250668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085360300 | ||||||||
| FaxNumber: | 8085360320 | ||||||||
| Practice Location | |||||||||
| Address1: | 1380 LUSITANA ST | ||||||||
| Address2: | SUITE 509 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8088888320 | ||||||||
| FaxNumber: | 8088888619 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2012 | ||||||||
| LastUpdateDate: | 01/13/2012 | ||||||||
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| AuthorizedOfficialLastName: | BRYANT-GREENWOOD | ||||||||
| AuthorizedOfficialFirstName: | BIANCA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8088888320 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD-15650 | HI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.