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Individual
STUART E BRAVERMAN
Active
Individual
STUART E BRAVERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
G61296
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
G61296
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G612960
BLUE SHIELD OF CA
CA
05
—
00G612960
—
CA
01
—
050396CF30626
TRAILBLAZER
—
01
—
P00324976
RAILROAD MEDICARE
—
Enumeration date
05/18/2006
Last updated
06/25/2024
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