Basic Information
| Provider Information | |||||||||
| NPI: | 1467848770 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROLLER | ||||||||
| FirstName: | BRYAN | ||||||||
| MiddleName: | ANDREW | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPARTMENT OF ANESTHESIOLOGY, B515 MAYO MEMORIAL BUILD | ||||||||
| Address2: | 420 DELAWARE STREET SE | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126249990 | ||||||||
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| Practice Location | |||||||||
| Address1: | DEPARTMENT OF ANESTHESIOLOGY, B515 MAYO MEMORIAL BUILD | ||||||||
| Address2: | 420 DELAWARE STREET SE | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126249990 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2015 | ||||||||
| LastUpdateDate: | 08/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 291896-1 | NY | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LC0200X | 71833 | MN | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207L00000X | 71833 | MN | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.