Organization
MIGUEL A BRAVO MD SURGICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL A BRAVO MD (MEDICAL DOCTOR OWNER)
(330) 602-7707
Entity
Organization
Contact information
Practice address
420 S JAMES ST, SUITE B, DOVER, OH 44622-3206
(330) 602-7707
(330) 602-6071
Mailing address
420 S JAMES ST, SUITE B, DOVER, OH 44622-3206
(330) 602-7707
(330) 602-6071
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
52476
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0933315
—
OH
Enumeration date
11/09/2007
Last updated
03/02/2012
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