Provider Demographics
NPI:1023261799
Name:BRAUN, SUSAN L (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:BRAUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4441 E MCDOWELL RD STE 101
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-4503
Mailing Address - Country:US
Mailing Address - Phone:602-273-6770
Mailing Address - Fax:602-267-8919
Practice Address - Street 1:6245 N 16TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-1706
Practice Address - Country:US
Practice Address - Phone:602-309-4709
Practice Address - Fax:602-419-2951
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2017-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ19984207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ171273Medicaid
AZ171273Medicaid