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NPI Code Detail

MEDICARE: DR. ELLORES ELBERTA BRAILEY MD

MEDICARE: DR. ELLORES ELBERTA BRAILEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician078605GA
2207V00000XObstetrics & Gynecology Physician27026NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225134588
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELLORES ELBERTA BRAILEY MD
Provider Business Mailing Address
First Line : PO BOX 100181
Second Line :
City : COLUMBIA
State : SC
Zip : 29202-3141
Country : US
Telephone Number : 828-202-5200
Fax Number :
Provider Business Practice Location Address
First Line : 77 MCDOWELL ST
Second Line :
City : ASHEVILLE
State : NC
Zip : 28801-4435
Country : US
Telephone Number : 828-257-4745
Fax Number : 828-407-4581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 04/09/2024

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