Individual
BARRY BRAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
17520 CHESTER ST, DETROIT, MI 48224-1212
(313) 884-0900
(313) 884-8062
Mailing address
16979 JEANETTE ST, SOUTHFIELD, MI 48075-1916
(248) 569-1506
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5101007774
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2808979
—
MI
Enumeration date
03/17/2006
Last updated
05/27/2011
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