Individual
PATSY S DETAMORE-BRUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
822 S 500 W, PORTLAND, IN 47371-8377
(260) 726-9027
(260) 726-9529
Mailing address
822 S 500 W, PORTLAND, IN 47371-8377
(260) 726-9027
(260) 726-9529
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01034065A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200006740
—
IN
Enumeration date
10/24/2006
Last updated
05/10/2017
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