Organization
MARSHALL F. BRUSTEIN M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARSHALL F. BRUSTEIN M.D. (OWNER)
(217) 872-8204
Entity
Organization
Contact information
Practice address
304 W HAY ST, SUITE 112, DECATUR, IL 62526-6328
(217) 872-8204
Mailing address
304 W HAY ST, SUITE 112, DECATUR, IL 62526-6328
(217) 872-8204
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036104593
IL
225X00000X
Occupational Therapist
056005019
IL
225X00000X
Occupational Therapist
056006099
IL
332B00000X
Durable Medical Equipment & Medical Supplies
036104593
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036104593
—
IL
Enumeration date
09/25/2008
Last updated
09/25/2008
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