MEDICARE: KENNETH J BRAMAN JR. DO

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	207Q00000X	Family Medicine Physician	34-005142	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	9338635	OTHER	OH	PARTNERS PHYSICIAN GROUP MEDICARE GROUP #

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	1841239274	OTHER	OH	PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649250374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH J BRAMAN JR. DO

Provider Business Mailing Address
First Line	:	1946 TOWN PARK BLVD
Second Line	:	#200
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-8372
Country	:	US
Telephone Number	:	330-896-3447
Fax Number	:	330-896-9919

Provider Business Practice Location Address
First Line	:	1946 TOWN PARK BLVD
Second Line	:	#200
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-8372
Country	:	US
Telephone Number	:	330-896-3447
Fax Number	:	330-896-9919

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	01/21/2015

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