Provider Demographics
NPI:1023209459
Name:DAVID A BRAUNER
Entity Type:Organization
Organization Name:DAVID A BRAUNER
Other - Org Name:PEDIATRIC CARDIOLOGY OF ALASKA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BEATY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-770-2301
Mailing Address - Street 1:PO BOX 196810
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99519-6810
Mailing Address - Country:US
Mailing Address - Phone:907-770-2301
Mailing Address - Fax:907-770-2325
Practice Address - Street 1:3260 PROVIDENCE DR
Practice Address - Street 2:SUITE 321
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4661
Practice Address - Country:US
Practice Address - Phone:907-261-3655
Practice Address - Fax:907-261-3160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty