Provider Demographics
NPI:1801845052
Name:BRAJAK, VLADIMIR JOSIP (DC)
Entity Type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:JOSIP
Last Name:BRAJAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38254 CHARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1225
Mailing Address - Country:US
Mailing Address - Phone:586-939-5742
Mailing Address - Fax:586-939-5742
Practice Address - Street 1:8023 GRAND RIVER RD
Practice Address - Street 2:SUITE 600
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9392
Practice Address - Country:US
Practice Address - Phone:810-494-9300
Practice Address - Fax:810-494-9320
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIVB007472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU67930OtherCIGNA
MI950E053640OtherBCBS
MI03-0585041OtherPPOM
MIU67930OtherHAP
MI7282762OtherAETNA
MIU67930Medicare UPIN
MI7282762OtherAETNA