Provider Demographics
NPI:1699734590
Name:BRANT, ZHANNA (MD)
Entity type:Individual
Prefix:DR
First Name:ZHANNA
Middle Name:
Last Name:BRANT
Suffix:
Gender:F
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:RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43403-0001
Mailing Address - Country:US
Mailing Address - Phone:419-372-2271
Mailing Address - Fax:419-372-8010
Practice Address - Street 1:RIDGE ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43403-0001
Practice Address - Country:US
Practice Address - Phone:419-372-2271
Practice Address - Fax:419-372-8010
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050070207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHF07899Medicare UPIN