Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 40038 | KY |
NPI | 1114962362 |
---|---|
Provider Name | Dr. David M Brey |
First Address | Owensboro, KY 42304-3229 |
Second Address | Owensboro, KY 42303-0877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 19/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64130719 | (05) | KY |