Provider Demographics
NPI:1124555073
Name:BRAUNTHAL, STEPHANIE GAIL (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:GAIL
Last Name:BRAUNTHAL
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Gender:F
Credentials:DO
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Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:PRC AND CREDENTIALING
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:100 DUDLEY STREET
Practice Address - Street 2:WIH OBSTETRIC AND CONSULTATIVE MEDICINE
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905
Practice Address - Country:US
Practice Address - Phone:401-453-7950
Practice Address - Fax:401-453-7748
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2023-07-14
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Provider Licenses
StateLicense IDTaxonomies
RIDO01094207R00000X
OH34.013777207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine