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Individual

DR. MARTIN BRIESCHKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1850 STATE ST, NEW ALBANY, IN 47150-4990
(502) 625-5584
(502) 426-2264
Mailing address
320 WHITTINGTON PKWY, SUITE 301, LOUISVILLE, KY 40222-4928
(502) 625-5584
(502) 426-2264

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01067924A
IN
207L00000X
Anesthesiology Physician
57010440
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000664767
ANTHEM
IN
01
115794
SIHO
IN
05
200984490
IN
01
3783137000
PASSPORT ADVANTAGE
IN
01
50028804
PASSPORT
IN
05
7100118850
KY
Enumeration date
05/25/2007
Last updated
05/04/2016
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