Provider Demographics
NPI:1649238478
Name:BRAUNEGG, PAUL W JR (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:W
Last Name:BRAUNEGG
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:66 ENTERPRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:17810-9260
Mailing Address - Country:US
Mailing Address - Phone:570-538-2613
Mailing Address - Fax:570-538-4665
Practice Address - Street 1:66 ENTERPRISE BLVD
Practice Address - Street 2:
Practice Address - City:ALLENWOOD
Practice Address - State:PA
Practice Address - Zip Code:17810-9260
Practice Address - Country:US
Practice Address - Phone:570-538-2613
Practice Address - Fax:570-538-4665
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA034452E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA534265Medicare PIN