David Bruce Braunstein, D.O.
Individual provider Active NPI Cardiovascular Disease Physician · Dyer, IN
NPI 1760460232 · NPPES record last updated Mar 9, 2011
Key facts
- NPI
- 1760460232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 02002225A (IN)
- Practice address
- 24 Joliet Street
Suite 401
Dyer, IN 46311 - Phone
- (219) 865-0893
- Fax
- (219) 865-3599
- NPI assigned
- Jan 5, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-049891 | IL | MD | Cardiovascular Disease Physician |
| 02002225 | IN | MD | Cardiovascular Disease Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 02002225 | IN | |
| Cardiovascular Disease Physician | 207RC0000X | 02002225A | IN | Yes |
| Cardiovascular Disease Physician | 207RC0000X | 036-049891 | IL |
Addresses
Primary practice location
24 Joliet Street
Suite 401
Dyer, IN 46311
Mailing address
3615 Park Drive
Suite 203
Olympia Fields, IL 60461
Phone (708) 748-9800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100363490A | Medicaid | IN |
Other providers in Dyer, IN
- Jessica Bosques
- Melissa Dawn Bourland
- Seth Bouwer
- Lauren Deann Bouwman
- Virginia E Bratcher
- Elizabet Braviere
- Briggs Ophthalmology & Associates, S.C.
- Karen Sue Briggs
- Mary Jo Brill
- Brilliant Minds LLC
All providers in Dyer, IN · Cardiovascular Disease Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.