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NPI 1487482667

NPI 1487482667 : BRADEN MILLAN : BETHESDA, MD

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General NPI Number Information
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    NPI Number           |    1487482667
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    Entity Type          |    Individual 
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    Provider Name        |    BRADEN MILLAN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/22/2024
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    Last Update Date     |    06/25/2025
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Provider Practice Location Address
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    Address Line         |    31 CENTER DR RM 3A11 
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    City                 |    BETHESDA
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    State                |    MD
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    Zip                  |    20892-0004
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    Country              |    US
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    Telephone            |    240-760-6400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    31 CENTER DR RM 3A11 
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    City                 |    BETHESDA
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    State                |    MD
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    Zip                  |    20892-0004
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    Country              |    US
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    Telephone            |    240-760-6400
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    Fax                  |    
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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        |    208800000X
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    Taxonomy Name        |    Urology Physician
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    License Number       |    MTR600002277
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    License Number State |    DC
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Taxonomy #2
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    Taxonomy Code        |    208800000X
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    Taxonomy Name        |    Urology Physician
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    License Number       |    118493
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    License Number State |    ZZ
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