Individual
DR. DIANE W BRAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1155 N MAYFAIR RD, SPINE CARE CLINIC AT PLANK ROAD, MILWAUKEE, WI 53226-3421
(414) 955-7199
(414) 955-0110
Mailing address
1155 N MAYFAIR RD, SPINE CARE CLINIC AT PLANK ROAD, MILWAUKEE, WI 53226-3421
(414) 955-7199
(414) 955-0110
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
29706
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000176N
HUMANA
—
05
—
1467404970
—
WI
Enumeration date
05/16/2006
Last updated
02/08/2013
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