Provider Demographics
NPI:1336769397
Name:LARGE, BRYAN PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:PAUL
Last Name:LARGE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:OHIOHEALTH DOCTORS HOSPITAL
Mailing Address - Street 2:5100 WEST BROAD STREET
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228
Mailing Address - Country:US
Mailing Address - Phone:614-544-1000
Mailing Address - Fax:614-544-1745
Practice Address - Street 1:OHIOHEALTH DOCTORS HOSPITAL
Practice Address - Street 2:5100 WEST BROAD STREET
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228
Practice Address - Country:US
Practice Address - Phone:614-544-1000
Practice Address - Fax:614-544-1745
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2024-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34.016614207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology