Individual
RANDY JOSEPH BRUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
6301 UNIVERSITY COMMONS, SUITE 210, SOUTH BEND, IN 46635-1571
(574) 234-4016
(574) 251-2095
Mailing address
6301 UNIVERSITY COMMONS, SUITE 210, SOUTH BEND, IN 46635-1571
(574) 234-4016
(574) 251-2095
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
99054700A
IN
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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