MEDICARE: MARGUERITE BRATHWAITE 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
1	207V00000X	Obstetrics & Gynecology Physician	8661	NV

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609846518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGUERITE BRATHWAITE MD

Provider Business Mailing Address
First Line	:	9811 W CHARLESTON BLVD STE 2-421
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7528
Country	:	US
Telephone Number	:	702-810-9797
Fax Number	:

Provider Business Practice Location Address
First Line	:	9811 W CHARLESTON BLVD STE 2-421
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7528
Country	:	US
Telephone Number	:	702-810-9797
Fax Number	:

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	05/31/2021

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Directions to “ MARGUERITE BRATHWAITE MD” Practice Location

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