Brasic, Gerlyn M
Brasic, Gerlyn M is an individual health care provider with primary practice located at 191 Theater Road , Onalaska WI 54650-8679. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Brasic, Gerlyn M can be contacted via phone (608) 392-5025.Contact Information
Primary practice address
191 Theater Road
Onalaska WI 54650-8679
Phone: (608) 392-5025
Fax: (608) 392-5788
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 44039 | Wisconsin |
Profile Details
| NPI number | 1033104427 |
|---|---|
| LBN Legal business name | Brasic, Gerlyn M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 13th, 2005 |
| Last updated | Jan 24th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033104427 | NPPES |
| Wisconsin | MEDICAID | 34179100 |
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