Provider Demographics
NPI:1609962778
Name:BEHAN, BRANISLAV D (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANISLAV
Middle Name:D
Last Name:BEHAN
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 1:2117 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-7607
Mailing Address - Country:US
Mailing Address - Phone:989-895-9500
Mailing Address - Fax:898-895-9600
Practice Address - Street 1:2117 16TH ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-7607
Practice Address - Country:US
Practice Address - Phone:989-895-9500
Practice Address - Fax:898-895-9600
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBB067457207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6084020001OtherMEDICARE NSC
MIP00142022OtherMEDICARE RAILROAD
MI2000931221OtherBLUE CROSS
MI104474336Medicaid
MI2000931221OtherBLUE CARE NETWORK
MI6084020001OtherMEDICARE NSC
MIP00142022OtherMEDICARE RAILROAD