Provider Demographics
NPI:1275724734
Name:BRAUN, MATTHEW MICHAEL (MOTR/L)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:MICHAEL
Last Name:BRAUN
Suffix:
Gender:M
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 CHERRY CREEK DR SOUTH
Mailing Address - Street 2:K200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4800 CHERRY CREEK SOUTH DR
Practice Address - Street 2:K200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-2292
Practice Address - Country:US
Practice Address - Phone:314-330-1460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006026881174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist