Individual
DR. JOHN W. BROVIAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2601 COOLIDGE RD, STE B, EAST LANSING, MI 48823-6361
(517) 913-4050
(517) 333-0893
Mailing address
2601 COOLIDGE RD, STE B, EAST LANSING, MI 48823-6361
(517) 913-4050
(517) 333-0893
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301034184
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0M54760003
MEDICARE PLUS BLUE
MI
01
—
1001247
MCLAREN HEALTH PLAN-MEDICAID
MI
01
—
110159644
RAILROAD MEDICARE
MI
01
—
1103351181
BCBS/BCN
MI
01
—
194055
PHCS
MI
01
—
200000001388
PHP
MI
05
—
3421169
—
MI
05
—
3421187
—
MI
01
—
5151077
AETNA
MI
Enumeration date
05/16/2006
Last updated
01/13/2010
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