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NPI Code Detail

MEDICARE: CHRISTOPHER BRAKE

MEDICARE: CHRISTOPHER BRAKE
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
1390200000XStudent in an Organized Health Care Education/Training Program11024873AIN

General Provider Information

NPI Number : 1033929864
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER BRAKE
Provider Business Mailing Address
First Line : PO BOX 781008
Second Line :
City : DETROIT
State : MI
Zip : 48278-1008
Country : US
Telephone Number : 317-528-4800
Fax Number : 317-865-1479
Provider Business Practice Location Address
First Line : 5230 E STOP 11 RD STE 250
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-6399
Country : US
Telephone Number : 317-528-8921
Fax Number : 317-528-6916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2025
Last Update Date : 06/09/2026

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Directions to “ CHRISTOPHER BRAKE ” Practice Location

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