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Individual
HERMAN WALLACE BRUBAKER
Active
Individual
HERMAN WALLACE BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD028694E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000908788
—
PA
01
—
080086589
RAILROAD MEDICARE
PA
01
—
120420409
DEPT OF LABOR
PA
01
—
122715
UNISON
PA
01
—
1806901
CAPITAL BLUECROSS
PA
01
—
247728
MAMSI
PA
01
—
25-1716306
DEVON
PA
01
—
426224
HEALTH AMERICA
PA
01
—
4397945
AETNA NON-HMO
PA
01
—
666058
FIRST HEALTH
PA
01
—
842753
AETNA HMO
PA
01
—
867633
MEDICARE GROUP #
PA
01
—
BR426736
HIGHMARK BLUE SHIELD
PA
01
—
MD028694E
LICENSE
PA
01
—
P006020
GATEWAY
PA
Enumeration date
06/13/2005
Last updated
03/07/2023
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