Provider Demographics
NPI:1609962778
Name:BEHAN, BRANISLAV D (MD)
Entity type:Individual
Prefix:DR
First Name:BRANISLAV
Middle Name:D
Last Name:BEHAN
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:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-1239
Mailing Address - Country:US
Mailing Address - Phone:573-248-1300
Mailing Address - Fax:573-248-5419
Practice Address - Street 1:6500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-6890
Practice Address - Country:US
Practice Address - Phone:573-629-3500
Practice Address - Fax:573-629-5889
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBB067457207X00000X
MO2025027549207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00142022OtherMEDICARE RAILROAD
MI2000931221OtherBLUE CROSS
MI2000931221OtherBLUE CARE NETWORK
MI104474336Medicaid
MI6084020001OtherMEDICARE NSC
MI6084020001OtherMEDICARE NSC
MIP00142022OtherMEDICARE RAILROAD