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1841278231

NPI Code Detail

MEDICARE: CHARLES BRAUN MD

MEDICARE: CHARLES BRAUN 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	82-15	NM
2	207RP1001X	Pulmonary Disease Physician	82-15	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	290013840	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	85031326887301A022	OTHER		CHAMPUS
2	NM009570	OTHER	NM	BC/BS
4	10002483	OTHER	NM	LOVELACE HEALTH/SALUD
5	201033382	OTHER	NM	PRESBYTERIAN HEALTH/SALUD
6	595796	OTHER	AZ	AHCCCS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	PROVP11372	OTHER	NM	MOLINA

General Provider Information

NPI Number	:	1841278231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES BRAUN MD

Provider Business Mailing Address
First Line	:	PO BOX 6210
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87499-6210
Country	:	US
Telephone Number	:	505-609-2258
Fax Number	:	505-609-2259

Provider Business Practice Location Address
First Line	:	801 W MAPLE ST
Second Line	:	SAN JUAN REGIONAL MEDICAL CENTER / HOSPITALISTS
City	:	FARMINGTON
State	:	NM
Zip	:	87401-5630
Country	:	US
Telephone Number	:	505-609-6463
Fax Number	:

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

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	10/29/2009

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Directions to “ CHARLES BRAUN MD” Practice Location

Language	Start Address	Practice Location

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