MEDICARE: PRECIOUS L BRASWELL 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	207VX0000X	Obstetrics Physician	055729	GA

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	:	1942207881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRECIOUS L BRASWELL MD

Provider Business Mailing Address
First Line	:	2885 HEADLAND DR
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-6652
Country	:	US
Telephone Number	:	404-344-9333
Fax Number	:	404-344-9922

Provider Business Practice Location Address
First Line	:	2885 HEADLAND DR
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-6652
Country	:	US
Telephone Number	:	404-344-9333
Fax Number	:	404-344-9922

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/25/2015

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Directions to “ PRECIOUS L BRASWELL MD” Practice Location

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