Individual
BRANDON WILLIAM ZABUKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 MEMORIAL DR STE 402, SOUTH BEND, IN 46601-1074
(574) 400-4550
(574) 400-4551
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01058060A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000483222
BCBS BMG CENTRAL NEIGHBORHOOD CTR
IN
01
—
000000488743
BCBS MAIN STREET
IN
01
—
000000488793
BCBS BMG E BLAIR WARNER
IN
01
—
000000789419
BCBS BMG CENTENNIAL NEIGHBORHOOD CTR
IN
05
—
200455430
—
IN
01
—
P00406499
RR MEDICARE
—
Enumeration date
12/09/2005
Last updated
10/19/2019
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