Provider Demographics
NPI:1104454222
Name:FERRIS, BRYANA (MD)
Entity type:Individual
Prefix:
First Name:BRYANA
Middle Name:
Last Name:FERRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 ERNEST W BARRETT PKWY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-4534
Mailing Address - Country:US
Mailing Address - Phone:678-354-2273
Mailing Address - Fax:770-794-6652
Practice Address - Street 1:1180 ERNEST W BARRETT PKWY NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-4534
Practice Address - Country:US
Practice Address - Phone:678-354-2273
Practice Address - Fax:770-794-6652
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA95671208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics