MEDICARE: DR. DANIEL JOSHUA BRUSTEIN 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	207R00000X	Internal Medicine Physician	35055654	OH
2	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	35055654	OH

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	:	1417920448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JOSHUA BRUSTEIN M.D.

Provider Business Mailing Address
First Line	:	2893 BERKSHIRE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2401
Country	:	US
Telephone Number	:	216-371-8488
Fax Number	:

Provider Business Practice Location Address
First Line	:	2893 BERKSHIRE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2401
Country	:	US
Telephone Number	:	216-371-8488
Fax Number	:

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	08/04/2020

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