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Individual

CESAR JOSE' BRAVO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306
Mailing address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306

Taxonomy

Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
0101-238615
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1790759645
ANTHEM
VA
05
1790759645
VA
01
371194700
OWCP
VA
01
3810006583
MEDICAID OF WEST VIRGINIA
VA
01
540506332004
TRICARE/CHAMPUS
VA
01
P00242289
RAILROAD MEDICARE
VA
Enumeration date
02/16/2006
Last updated
12/01/2017
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