| Doctor Name: | BARRY BRAVER |
| NPI Number: | 1275592412 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 5101007774 |
| Business Practice Address: | 17520 Chester St Detroit, MI - 482241212 |
| Business Phone Number: | 3138840900 |
| Business Fax Number: | 3138848062 |
| Mailing Address: | 16979 Jeanette St, SOUTHFIELD |
| State: | MI |
| Postal Code: | 480751916 |
| Phone Number: | 2485691506 |
| Fax Number: | |
| NPI Enumeration Date: | 03/17/2006 |
| NPI Last Update Date: | 05/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101007774 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |