Healthcare Provider Details

I. General information

NPI: 1477529824
Provider Name (Legal Business Name): MARY F BRAUN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 01/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 S MAIN ST
NEWMARKET NH
03857-1843
US

IV. Provider business mailing address

25 S RIVER RD
BEDFORD NH
03110-6708
US

V. Phone/Fax

Practice location:
  • Phone: 603-659-3106
  • Fax:
Mailing address:
  • Phone: 603-629-2572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number12524
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: