MEDICARE: AMY M BRADEN 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	207RH0003X	Hematology & Oncology Physician	02004953A	IN
2	207RH0003X	Hematology & Oncology Physician	2022038968	MO
3	207RH0003X	Hematology & Oncology Physician	05-46523	KS

General Provider Information

NPI Number	:	1750556684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY M BRADEN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 749495
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-9495
Country	:	US
Telephone Number	:	855-963-2100
Fax Number	:	813-321-1296

Provider Business Practice Location Address
First Line	:	8301 HARCOURT RD STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2082
Country	:	US
Telephone Number	:	317-415-6600
Fax Number	:	317-415-6649

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

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	12/15/2025

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