Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 01058475 | IN |
NPI | 1033196241 |
---|---|
Provider Name | Lori A Brame |
First Address | Chicago, IL 60677-5985 |
Second Address | Noblesville, IN 46060-1425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 18/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000322832 | ANTHEM (01) | IN |
200470090 | (05) | IN |
I06687 | (02) | |
Q0424127 | SHO (01) | IN |