Provider Demographics
NPI:1194785709
Name:BRAZIER, CRESSEY W (MD)
Entity type:Individual
Prefix:
First Name:CRESSEY
Middle Name:W
Last Name:BRAZIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 HURD POINT RD
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04429-4221
Mailing Address - Country:US
Mailing Address - Phone:207-843-7914
Mailing Address - Fax:207-454-9265
Practice Address - Street 1:22 HOSPITAL LN
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1329
Practice Address - Country:US
Practice Address - Phone:207-454-9213
Practice Address - Fax:207-454-9265
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME008277207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME15507Medicare ID - Type Unspecified
C66422Medicare UPIN