Individual
DANIEL ALLEN BRAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 S NATIONAL AVE STE 600, SPRINGFIELD, MO 65807
(417) 875-3846
Mailing address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3462
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2019026844
MO
207XX0801X
Orthopaedic Trauma Physician
Primary
2019026844
MO
207XX0801X
Orthopaedic Trauma Physician
A153736
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200072314
—
MO
Enumeration date
06/03/2013
Last updated
09/12/2019
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