MEDICARE: DR. MARK EDWARD BRAUNER D.O.

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
1	207PH0002X	Hospice and Palliative Medicine (Emergency Medicine) Physician	34.008897	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1588870950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK EDWARD BRAUNER D.O.

Provider Business Mailing Address
First Line	:	2619 WELLESLEY RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-2957
Country	:	US
Telephone Number	:	614-231-2619
Fax Number	:

Provider Business Practice Location Address
First Line	:	2619 WELLESLEY RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-2957
Country	:	US
Telephone Number	:	614-231-2619
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	04/01/2009

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