Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | MD33551 | DC |
NPI | 1184645988 |
---|---|
Provider Name | Martin Alan Braun |
First Address | Washington, DC 20037-2715 |
Second Address | Washington, DC 20037-2715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H86504 | (02) | DC |