1235351263 NPI number — NAVKIRANJOT BRAR MD

Table of content: NAVKIRANJOT BRAR MD (NPI 1235351263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235351263 NPI number — NAVKIRANJOT BRAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRAR
Provider First Name:
NAVKIRANJOT
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235351263
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
45640 SCHOENHERR RD
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
SHELBY TOWNSHIP
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48315-6033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-247-4300
Provider Business Mailing Address Fax Number:
586-532-6496

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45640 SCHOENHERR RD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
SHELBY TOWNSHIP
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48315-6033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-247-4300
Provider Business Practice Location Address Fax Number:
586-532-6496
Provider Enumeration Date:
05/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  4301083823 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RH0005X , with the licence number: 4301083823 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0-646-311-1 . This is a "ECFMG" identifier . This identifiers is of the category "OTHER".




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