Provider Demographics
NPI:1649362799
Name:BRASH, DANIEL W (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:BRASH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3800 HOLLYWOOD RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-8510
Mailing Address - Country:US
Mailing Address - Phone:269-428-0819
Mailing Address - Fax:269-428-0841
Practice Address - Street 1:3800 HOLLYWOOD RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-8510
Practice Address - Country:US
Practice Address - Phone:269-428-0819
Practice Address - Fax:269-428-0841
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2009-12-15
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Provider Licenses
StateLicense IDTaxonomies
MI4301049804207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4382000Medicaid
MI110A110400OtherBLUE CROSS BLUE SHIELD
MI0N27670Medicare ID - Type Unspecified
MI4382000Medicaid