Provider Demographics
NPI:1093921280
Name:BRAUN, MELISSA ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANN
Last Name:BRAUN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:SWANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:350 W THOMAS RD SURGICAL SUITE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013
Mailing Address - Country:US
Mailing Address - Phone:602-406-3541
Mailing Address - Fax:602-406-7135
Practice Address - Street 1:350 W THOMAS RD SURGICAL SUITE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013
Practice Address - Country:US
Practice Address - Phone:602-406-3541
Practice Address - Fax:602-406-7135
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4660207LP3000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ226436Medicaid
AZ226436Medicaid