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NPI Code Detail

MEDICARE: DR. DAVID WILLIAM BRAY PHARMD

MEDICARE: DR. DAVID WILLIAM BRAY PHARMD
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
1183500000XPharmacist124717MN

General Provider Information

NPI Number : 1689278731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID WILLIAM BRAY PHARMD
Provider Business Mailing Address
First Line : 8936 LYNDALE AVE S
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55420-2742
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8936 LYNDALE AVE S
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55420-2742
Country : US
Telephone Number : 952-881-0163
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2020
Last Update Date : 11/29/2020

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