Provider Demographics
NPI:1417148784
Name:BRAUMILLER PSYCHIATRIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:BRAUMILLER PSYCHIATRIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BRAUMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-291-0130
Mailing Address - Street 1:143 VALENTINE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1923
Mailing Address - Country:US
Mailing Address - Phone:937-298-5333
Mailing Address - Fax:937-298-5923
Practice Address - Street 1:143 VALENTINE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-1923
Practice Address - Country:US
Practice Address - Phone:937-298-5333
Practice Address - Fax:937-298-5923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-02
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.0058312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2032973Medicaid
OHBR4036191Medicare PIN
OH2032973Medicaid