Healthcare Provider Details
I. General information
NPI: 1831415082
Provider Name (Legal Business Name): BRITTANY RABURN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/13/2010
Last Update Date: 02/24/2021
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1513 S MAIN ST
CHELSEA MI
48118-1434
US
IV. Provider business mailing address
24 FRANK LLOYD WRIGHT DR LBBY J2000
ANN ARBOR MI
48105-9484
US
V. Phone/Fax
- Phone: 734-475-9175
- Fax: 734-475-0120
- Phone: 734-747-6766
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 4301107119 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: