Provider Demographics
NPI:1841355476
Name:TRUAX, BRAD (MD)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:
Last Name:TRUAX
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 1:10880 E COUNTY ROAD 450 S
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:IN
Mailing Address - Zip Code:47383-9771
Mailing Address - Country:US
Mailing Address - Phone:765-282-4197
Mailing Address - Fax:
Practice Address - Street 1:1500 NEELEY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47306-0001
Practice Address - Country:US
Practice Address - Phone:765-285-8431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040975207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine