Provider Demographics
NPI:1891766226
Name:BRAUDE, DARREN (MD)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:BRAUDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 UNIVERSITY BLVD NE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1726
Mailing Address - Country:US
Mailing Address - Phone:505-272-8950
Mailing Address - Fax:
Practice Address - Street 1:2211 LOMAS BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2745
Practice Address - Country:US
Practice Address - Phone:505-272-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2001-19207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
85031326887301A173OtherCHAMPUS
NMPROVP11405OtherMOLINA
P00165569OtherRAILROAD MEDICARE
NMB8413Medicaid
NM10001002OtherLOVELACE HEALTH/SALUD
NM201027588OtherPRESBYTERIAN HEALTH/SALUD
G91278Medicare UPIN
NMB8413Medicaid