Individual
DR. JEFFREY REX BRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-2000
Mailing address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-2000
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
44515
MN
2085R0202X
Diagnostic Radiology Physician
Primary
44515
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0091681
—
MT
05
—
0589325
—
IA
01
—
1034029
PREFERRED ONE
MN
01
—
16-02032
MEDICA PRIMARY
MN
01
—
16-03496
MEDICA CHOICE
MN
01
—
17131
UCARE
MN
01
—
1811611
ARAZ
MN
05
—
330412400
—
MN
05
—
34612300
—
WI
01
—
588T5BR
BCBS
MN
01
—
B592
CHAMPUS/TRIWEST
MN
01
—
HP44290
HEALTHPARTNERS
MN
01
—
P00253879
RAILROAD MEDICARE
MN
Enumeration date
06/28/2006
Last updated
07/07/2021
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