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General NPI Number Information
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NPI Number | 1598151383
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Entity Type | Individual
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Provider Name | DAVID VINCENT BRAITMAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 05/17/2025
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Provider Practice Location Address
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Address Line | 1002 WISHARD BLVD
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-4163
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Country | US
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Telephone | 317-944-8162
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Fax |
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 01086449A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | RS2015-0391
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01086449A
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License Number State | IN
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