Provider Demographics
NPI:1700863826
Name:BRABEC, BRADFORD A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:A
Last Name:BRABEC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8201 NORTHWOODS DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-3092
Mailing Address - Country:US
Mailing Address - Phone:402-465-5600
Mailing Address - Fax:402-327-6074
Practice Address - Street 1:4020 HOHENSEE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3927
Practice Address - Country:US
Practice Address - Phone:402-465-5600
Practice Address - Fax:402-327-6074
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE19675208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47079049100Medicaid