Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | LL38426 | SC |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | A173830 | CA |
NPI | 1235512930 |
---|---|
Provider Name | Dr. Jacob Braunstein |
First Address | Charleston, SC 29425-8905 |
Second Address | Charleston, SC 29425-8905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2015 |
Last Update Date | 10/08/2021 |