Provider Demographics
NPI:1346814787
Name:MARGUERITE BRATHWAITE MD PLLC
Entity Type:Organization
Organization Name:MARGUERITE BRATHWAITE MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-556-6175
Mailing Address - Street 1:9811 W CHARLESTON BLVD STE 2-421
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7528
Mailing Address - Country:US
Mailing Address - Phone:702-413-7740
Mailing Address - Fax:702-413-7975
Practice Address - Street 1:7650 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2750
Practice Address - Country:US
Practice Address - Phone:702-413-7740
Practice Address - Fax:702-413-7975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-19
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty