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General NPI Number Information
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NPI Number | 1144388406
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Entity Type | Individual
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Provider Name | FREDERIC H.T. BRAUN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3001 SQUALICUM PKWY SUITE 11
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City | BELLINGHAM
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State | WA
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Zip | 98225-1949
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Country | US
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Telephone | 360-733-3696
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Fax | 360-733-9202
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Provider Business Mailing Address
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Address Line | 3001 SQUALICUM PKWY SUITE 11
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City | BELLINGHAM
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State | WA
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Zip | 98225-1949
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Country | US
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Telephone | 360-733-3696
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Fax | 360-733-9202
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD00013524
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License Number State | WA
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