DR. CANDACE VICTORIA BRYAN M.D. NPI 1376750133

NPI Information

NPI: 1376750133
Provider Name: DR. CANDACE VICTORIA BRYAN, M.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
3020 HAMAKER CT
SUITE #400
FAIRFAX, VA
ZIP 22031
Phone: (703) 876-0800
Get Directions

DR. Candace Victoria Bryan, M.D. is a neurology psychiatry neurology in Fairfax, VA with 21 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. DR. Candace Victoria Bryan, M.D. NPI is 1376750133. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
Graduation Year:2003

The provider's business location address is:

3020 HAMAKER CT
SUITE #400
FAIRFAX, VA
ZIP 22031-238
Phone: (703) 876-0800
Fax: (703) 876-0866

The NPI 1376750133 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/17/2007 and was last updated on 6/8/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084B0040X	Psychiatry & Neurology	Behavioral Neurology & Neuropsychiatry	0101242056	VIRGINIA	No
2	2084N0400X	Psychiatry & Neurology	Neurology	010124056	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1376750133	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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