Provider Demographics
NPI:1558580902
Name:BRAUD, MARY MARGARET (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:MARGARET
Last Name:BRAUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2652 S MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2628
Mailing Address - Country:US
Mailing Address - Phone:303-721-2901
Mailing Address - Fax:303-721-2905
Practice Address - Street 1:8089 S LINCOLN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2700
Practice Address - Country:US
Practice Address - Phone:303-721-2901
Practice Address - Fax:303-721-2905
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO318372084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF54134Medicare UPIN