Individual
JOHN M BRAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 FRANCIS ST, RADIOLOGY, BRIGHAM & WOMEN'S HOSPITAL, BOSTON, MA 02115-6110
(617) 732-6295
(617) 535-7333
Mailing address
75 FRANCIS ST, RADIOLOGY, BRIGHAM & WOMEN'S HOSPITAL, BOSTON, MA 02115-6110
(617) 732-6295
(617) 264-5151
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
37202
MA
2085R0202X
Diagnostic Radiology Physician
Primary
37202
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037202
TUFTS HEALTH CARE
MA
05
—
2057398
—
MA
01
—
M09556
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/11/2005
Last updated
08/02/2012
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