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NPI Code Detail

MEDICARE: DR. SAMI BRAKE MD

MEDICARE: DR. SAMI BRAKE MD
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
1207RX0202XMedical Oncology Physician4301085894MI

Other Identifiers

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

General Provider Information

NPI Number : 1043416811
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMI BRAKE MD
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE # MC845
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 145 MICHIGAN ST NE STE 2200
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2562
Country : US
Telephone Number : 616-486-5933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2007
Last Update Date : 03/12/2026

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