Individual
DR. BRIAN JAMES MADURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
101 20TH ST N, BATTLE CREEK, MI 49015-1701
(269) 963-1746
Mailing address
101 20TH ST N, BATTLE CREEK, MI 49015-1701
(269) 963-1746
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901017417
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17417
BLUE CROSS AND BLU SHIELD
MI
01
—
383616883
TAX ID, DELTA
MI
Enumeration date
11/20/2006
Last updated
07/08/2007
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