Organization Name: | BRAINERD MEDICAL CENTER INC |
NPI Number: | 1295801777 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID L PILIT (CFO) |
Mailing Address: | 2024 S 6th St Brainerd |
State: | MN US |
Postal Code: | 564014529 |
Phone Number: | 2188287100 |
Fax Number: | 2188287194 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 12/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 8619454 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |