Individual
JOSHUA A. NIEBRUEGGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4550 MEMORIAL DR, STE. 340, BELLEVILLE, IL 62226-5372
(618) 257-6200
(618) 257-6679
Mailing address
2100 POWELL ST, STE 900, EMERYVILLE, CA 94608-1844
(510) 851-7423
(510) 879-9120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036127134
IL
208M00000X
Hospitalist Physician
036127134
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036127134
—
IL
Enumeration date
07/10/2008
Last updated
12/21/2017
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