Provider Demographics
NPI:1326729914
Name:ADVENT HEALTH MEDICAL GROUP PRIMARY CARE AT DURAND NORTH
Entity Type:Organization
Organization Name:ADVENT HEALTH MEDICAL GROUP PRIMARY CARE AT DURAND NORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRADY
Authorized Official - Middle Name:P
Authorized Official - Last Name:DIDION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:715-672-5981
Mailing Address - Street 1:905 7TH AVE W
Mailing Address - Street 2:
Mailing Address - City:DURAND
Mailing Address - State:WI
Mailing Address - Zip Code:54736
Mailing Address - Country:US
Mailing Address - Phone:715-672-5981
Mailing Address - Fax:715-672-3538
Practice Address - Street 1:905 7TH AVE W
Practice Address - Street 2:
Practice Address - City:DURAND
Practice Address - State:WI
Practice Address - Zip Code:54736
Practice Address - Country:US
Practice Address - Phone:715-672-5981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty