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Individual

DR. SRBISLAV N BRASOVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
111 W 10TH ST, SUITE 100, HOBART, IN 46342-5990
(219) 738-2742
(219) 942-0740
Mailing address
7903 E 97TH AVE, CROWN POINT, IN 46307-8599
(219) 738-2742
(219) 942-0740

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
01022104A
IN
207VG0400X
Gynecology Physician
036103826
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000229829
BLUECROSSBLUESHIELD
IN
Enumeration date
12/16/2006
Last updated
08/04/2010
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