Provider Demographics
NPI:1568482081
Name:BRUSCHWEIN, DEAN A (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:A
Last Name:BRUSCHWEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35100
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-5100
Mailing Address - Country:US
Mailing Address - Phone:406-238-2500
Mailing Address - Fax:
Practice Address - Street 1:2800 10TH AVE N
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0703
Practice Address - Country:US
Practice Address - Phone:406-238-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT47692085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT8HZM56OtherMEDICARE LG
MT000016900OtherBCBS PIN
MT0012223OtherMDCD PIN
MT8HZN24OtherMEDICARE PRYOR
WY103073600OtherMDCD PIN
MT8HZN68OtherMEDICARE CROW
MT000080892Medicare PIN
MT0012223OtherMDCD PIN
MT8HZM56OtherMEDICARE LG
MT8HZN68OtherMEDICARE CROW