Healthcare Provider Details

I. General information

NPI: 1447888672
Provider Name (Legal Business Name): ALEXANDER FREDERIC LUDWIG BRAUER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4614 COUNTRY CLUB RD
WINSTON SALEM NC
27104-3520
US

IV. Provider business mailing address

MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-3787
  • Fax: 336-716-0222
Mailing address:
  • Phone: 336-716-3787
  • Fax: 336-716-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number12403938-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2026-02808
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: