Individual
MANDEEP BRAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1201 MICHIGAN AVE, SUITE 270, LOGANSPORT, IN 46947-1580
(574) 722-4921
(574) 739-0520
Mailing address
117 W PATERSON ST, KALAMAZOO, MI 49007-2557
(269) 349-2641
(269) 488-8972
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704347087
MI
363LF0000X
Family Nurse Practitioner
71006503A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001051082
ANTHEM
IN
05
—
201391250
—
IN
01
—
P01727211
RAILROAD MEDICARE
IN
Enumeration date
09/06/2016
Last updated
12/27/2022
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