Healthcare Provider Details

I. General information

NPI: 1184645988
Provider Name (Legal Business Name): MARTIN ALAN BRAUN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 F ST NW SUITE #701
WASHINGTON DC
20037-2715
US

IV. Provider business mailing address

2112 F ST NW SUITE #701
WASHINGTON DC
20037-2715
US

V. Phone/Fax

Practice location:
  • Phone: 202-293-7618
  • Fax: 202-775-1772
Mailing address:
  • Phone: 202-293-7618
  • Fax: 202-775-1772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberMD33551
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: