Individual
SAMUEL BRAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5816 OSAGE BEACH PKWY, SUITE 108, OSAGE BEACH, MO 65065-3046
(573) 636-3313
(573) 636-5881
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
(573) 636-5881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R1E19
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241989565
—
MO
Enumeration date
07/12/2006
Last updated
01/14/2014
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