Provider Demographics
NPI:1467457580
Name:BRAU, STEVEN J
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:BRAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 4TH ST SW STE 310
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2856
Mailing Address - Country:US
Mailing Address - Phone:641-423-3367
Mailing Address - Fax:641-423-3368
Practice Address - Street 1:1010 4TH ST SW STE 310
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2856
Practice Address - Country:US
Practice Address - Phone:641-423-3367
Practice Address - Fax:641-423-3368
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2011-09-01
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
IA374213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0184705Medicaid
IA0184705Medicaid
IA18470Medicare PIN
IA0135000001Medicare NSC