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NPI Code Detail

MEDICARE: MR. JOHN A BREDA MD

MEDICARE: MR. JOHN A BREDA 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
1207R00000XInternal Medicine Physician155371MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10402531OTHERMAUNITED HEALTHCARE
2J19984OTHERMABCBSMA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508835653
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN A BREDA MD
Provider Business Mailing Address
First Line : 465 S WASHINGTON ST
Second Line :
City : NORTH ATTLEBORO
State : MA
Zip : 02760-2159
Country : US
Telephone Number : 508-316-0725
Fax Number : 508-316-1685
Provider Business Practice Location Address
First Line : 2181 ORANGE AVE E
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32311-6144
Country : US
Telephone Number : 617-877-0025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 10/07/2022

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