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Individual

JEFFREY A BREALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-0561
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01052687
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
01052687A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01052687A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01052687A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060066286
RAILROAD MEDICARE
IN
05
200287770
IN
01
60060231
RAILROAD MEDICARE
IN
Enumeration date
04/17/2006
Last updated
01/27/2021
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