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NPI Code Detail

MEDICARE: MR. MICHAEL J BRUBAKER D.O.

MEDICARE: MR. MICHAEL J BRUBAKER D.O.
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
1207Q00000XFamily Medicine Physician02001339AIN

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 : 1336149061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL J BRUBAKER D.O.
Provider Business Mailing Address
First Line : 1400 E 9TH ST
Second Line :
City : ROCHESTER
State : IN
Zip : 46975-8931
Country : US
Telephone Number : 574-223-3141
Fax Number : 574-223-5847
Provider Business Practice Location Address
First Line : 1432 E 9TH ST
Second Line :
City : ROCHESTER
State : IN
Zip : 46975-8931
Country : US
Telephone Number : 574-223-4337
Fax Number : 574-406-9116
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 12/04/2025

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