MEDICARE: DR. CHAD BRADEN MD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD13519R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447217336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAD BRADEN MD

Provider Business Mailing Address
First Line	:	9001 SUMMA AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3726
Country	:	US
Telephone Number	:	225-761-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	9001 SUMMA AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3726
Country	:	US
Telephone Number	:	225-761-5480
Fax Number	:	225-761-5487

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	12/06/2007

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Directions to “ DR. CHAD BRADEN MD” Practice Location

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