Individual
TODD A MOYER-BRAILEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4660 S HAGADORN RD STE 210, EAST LANSING, MI 48823-5353
(517) 355-4205
(517) 364-8119
Mailing address
804 SERVICE RD, STE A109B, EAST LANSING, MI 48824-7015
(517) 355-4205
(517) 355-4202
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
5101009519
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700054
PHP PROVIDER #
MI
01
—
0770054
PHP FAMILYCARE PROVIDER#
MI
01
—
1011190
MCLAREN PROVIDER #
MI
01
—
160045101
RR MEDICARE PROVIDER #
MI
05
—
3418824
—
MI
01
—
5331613
BCBS/BCN PROVIDER #
MI
Enumeration date
03/07/2006
Last updated
06/27/2023
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