Provider Demographics
NPI:1932105764
Name:BRAUN, JEAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:B
Last Name:BRAUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BIERER LN
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-3117
Mailing Address - Country:US
Mailing Address - Phone:724-439-2574
Mailing Address - Fax:724-439-4533
Practice Address - Street 1:105 BIERER LN
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3117
Practice Address - Country:US
Practice Address - Phone:724-439-2574
Practice Address - Fax:724-439-4533
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012675E174400000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA633022Medicare ID - Type UnspecifiedPROVIDER NUMBER
PA071475V4BMedicare PIN
PA071475V4CMedicare PIN
PAC28958Medicare UPIN
PAP00772108Medicare PIN