MEDICARE: DR. ZHANNA BRANT 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
1	207Q00000X	Family Medicine Physician	35050070	OH

General Provider Information

NPI Number	:	1699734590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZHANNA BRANT MD

Provider Business Mailing Address
First Line	:	RIDGE ST
Second Line	:
City	:	BOWLING GREEN
State	:	OH
Zip	:	43403-0001
Country	:	US
Telephone Number	:	419-372-2271
Fax Number	:	419-372-8010

Provider Business Practice Location Address
First Line	:	RIDGE ST
Second Line	:
City	:	BOWLING GREEN
State	:	OH
Zip	:	43403-0001
Country	:	US
Telephone Number	:	419-372-2271
Fax Number	:	419-372-8010

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

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	07/08/2007

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