Provider Demographics
NPI:1063681021
Name:BRELAGE, GLORIA J (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:J
Last Name:BRELAGE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-0236
Mailing Address - Country:US
Mailing Address - Phone:812-933-5441
Mailing Address - Fax:812-933-5446
Practice Address - Street 1:26 SIX PINE RANCH RD
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-1399
Practice Address - Country:US
Practice Address - Phone:812-934-5252
Practice Address - Fax:812-934-5337
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2021-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01068670A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine