Provider Demographics
NPI:1396816435
Name:BRAUM, MORRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:
Last Name:BRAUM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4524 JAMERSON FOREST PKWY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-1127
Mailing Address - Country:US
Mailing Address - Phone:770-928-0163
Mailing Address - Fax:
Practice Address - Street 1:4524 JAMERSON FOREST PKWY
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-1127
Practice Address - Country:US
Practice Address - Phone:770-928-0163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCBQSMedicare ID - Type Unspecified