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Individual

DR. STEVEN P. BRASCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1630 30TH ST STE A, BOULDER, CO 80301-1045
(720) 938-1978
Mailing address
1630 30TH ST STE A, BOULDER, CO 80301-1045
(720) 938-1978

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-062218
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036-062218
STATE OF ILLINOIS LICENSED PHYSICIAN AND SURGEON
IL
05
036062218
IL
Enumeration date
09/13/2006
Last updated
11/06/2012
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