Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 35061693 | OH |
NPI | 1255378196 |
---|---|
Provider Name | Mark Brejt |
First Address | Cleveland, OH 44118-1906 |
Second Address | Cleveland, OH 44118-1906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 04/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000221357 | UNISON (01) | OH |
000000503601 | ANTHEM (01) | OH |
0018157540006 | (05) | PA |
0304914 | BCMH (01) | OH |
0907853 | (05) | OH |
363378 | WELLCARE (01) | OH |
4334561 | AETNA (01) | OH |
745377 | BUCKEYE (01) | OH |
E57903 | (02) | OH |
P00412293 | RAILROAD MEDICARE (01) | OH |