Individual
DR. GARY MICHAEL BRIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4423 MANCHESTER DR, ROCKFORD, IL 61109-1655
(815) 394-1391
(815) 226-0114
Mailing address
9388 STEEPLEBUSH DR, BELVIDERE, IL 61008-7120
(815) 332-1785
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-068930
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
834340
MEDICARE GROUP #
IL
Enumeration date
01/03/2006
Last updated
01/30/2009
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