MEDICARE: JULIE BRAGG CFOM., CPED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	224900000X	Mastectomy Fitter
2	224L00000X	Pedorthist
3	225000000X	Orthotic Fitter

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	046KY	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093863862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE BRAGG CFOM., CPED

Provider Business Mailing Address
First Line	:	3824 BARRETT DR STE 102
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7220
Country	:	US
Telephone Number	:	919-441-0023
Fax Number	:	919-594-1175

Provider Business Practice Location Address
First Line	:	3824 BARRETT DR STE 102
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7220
Country	:	US
Telephone Number	:
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	03/28/2022

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