Dylan Bray, AA | |
225 S Executive Dr, Brookfield, WI 53005-4257 | |
(608) 770-0908 | |
Not Available |
Full Name | Dylan Bray |
---|---|
Gender | Male |
Speciality | Anesthesiologist Assistant |
Location | 225 S Executive Dr, Brookfield, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790135457 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | 82-17 (Wisconsin) | Primary |
367H00000X | Anesthesiologist Assistant | ANT.0000131 (Colorado) | Secondary |
Entity Name | Aurora Medical Group, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Entity Name | Madison Anesthesiology Consultants, Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669550711 PECOS PAC ID: 5193700342 Enrollment ID: O20040622000357 |
Entity Name | Columbia St Marys Hospital Milwaukee Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073832218 PECOS PAC ID: 5890604722 Enrollment ID: O20101101000597 |
Mailing Address | Practice Location Address |
---|---|
Dylan Bray, AA 2135 N Lake Dr, Milwaukee, WI 53202-1334 Ph: () - | Dylan Bray, AA 225 S Executive Dr, Brookfield, WI 53005-4257 Ph: (608) 770-0908 |
Tia Covington Harris, AA-C Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 225 S Executive Dr, Brookfield, WI 53005 Phone: 262-787-6758 | |
Mr. Justin Matthew Kitson, CAA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 225 S Executive Dr, Brookfield, WI 53005 Phone: 262-787-6758 |