Healthcare Provider Details

I. General information

NPI: 1417148784
Provider Name (Legal Business Name): BRAUMILLER PSYCHIATRIC ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2007
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 VALENTINE DR
DAYTON OH
45431-1923
US

IV. Provider business mailing address

143 VALENTINE DR
DAYTON OH
45431-1923
US

V. Phone/Fax

Practice location:
  • Phone: 937-298-5333
  • Fax: 937-298-5923
Mailing address:
  • Phone: 937-298-5333
  • Fax: 937-298-5923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number34.005831
License Number StateOH

VIII. Authorized Official

Name: DR. BRIAN MICHAEL BRAUMILLER
Title or Position: PROPRIETER
Credential: D.O.
Phone: 937-291-0130