Individual
STUART J BRAVERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 W 10TH ST, SEDALIA, MO 65301-2111
(660) 827-0423
(660) 827-5510
Mailing address
3300 W 10TH ST, SEDALIA, MO 65301-2111
(660) 827-0423
(660) 827-5510
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
100311
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020036256
RR MEDICARE
MO
05
—
203303201
—
MO
Enumeration date
08/19/2005
Last updated
10/08/2014
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