Healthcare Provider Details

I. General information

NPI: 1336101237
Provider Name (Legal Business Name): MICHAEL HOLMAN BRAVE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 WADE AVE SPRING GROVE HOSPITAL CENTER
CATONSVILLE MD
21228-4663
US

IV. Provider business mailing address

8712 CAMERON ST APARTMENT 203
SILVER SPRING MD
20910-3701
US

V. Phone/Fax

Practice location:
  • Phone: 410-402-6000
  • Fax:
Mailing address:
  • Phone: 443-695-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License NumberD36131
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: