MEDICARE: DR. ADAM W. BRAZUS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	01041551	IN
2	207W00000X	Ophthalmology Physician	01041551	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144286311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM W. BRAZUS M.D.

Provider Business Mailing Address
First Line	:	13250 HAZEL DELL PKWY STE 101
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46033-8527
Country	:	US
Telephone Number	:	317-872-1121
Fax Number	:	317-810-1379

Provider Business Practice Location Address
First Line	:	13250 HAZEL DELL PKWY STE 101
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46033-8527
Country	:	US
Telephone Number	:	317-872-1121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	09/08/2023

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