Braun, David A

Braun, David A is an individual health care provider with primary practice located at 1505 Eastland Dr Suite 1100, Bloomington IL 61701-3591. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Braun, David A can be contacted via phone (309) 663-2100.

Contact Information

Primary practice address
1505 Eastland Dr Suite 1100 Bloomington IL 61701-3591
Phone: (309) 663-2100
Fax: (309) 663-8322
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036104222 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 33372 Iowa

Profile Details

NPI number 1568422806
LBN Legal business name Braun, David A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Oct 13th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568422806 NPPES
Other IL2613 MEDICARE GROUP #
Other P00748543 MEDICARE GROUP #
Other 70254 MEDICARE GROUP #
Other 833120 MEDICARE GROUP #
MEDICAID SS# NOT ENTERED MEDICARE GROUP #
Other CA2264 MEDICARE GROUP #

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