Provider Demographics
NPI:1942436134
Name:NEDICH, BRETT LAWRENCE (DO)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:LAWRENCE
Last Name:NEDICH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:720 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-8778
Mailing Address - Country:US
Mailing Address - Phone:316-283-6103
Mailing Address - Fax:316-283-1333
Practice Address - Street 1:126 MAIN ST
Practice Address - Street 2:
Practice Address - City:HALSTEAD
Practice Address - State:KS
Practice Address - Zip Code:67056-1708
Practice Address - Country:US
Practice Address - Phone:316-835-3700
Practice Address - Fax:316-283-1333
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS05-35993207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine