Provider Demographics
NPI:1265272066
Name:BRAUN, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:BRAUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 WINYAH ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440-4730
Mailing Address - Country:US
Mailing Address - Phone:843-359-5758
Mailing Address - Fax:843-527-1697
Practice Address - Street 1:1423 WINYAH ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-4730
Practice Address - Country:US
Practice Address - Phone:843-546-6081
Practice Address - Fax:843-527-1697
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2283175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist