Provider Demographics
NPI:1295879294
Name:BRABER, THOMAS KENNETH
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:KENNETH
Last Name:BRABER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USCG HEADQUARTERS CLINIC
Mailing Address - Street 2:2100 2ND STREET SW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20590-0001
Mailing Address - Country:US
Mailing Address - Phone:202-372-4100
Mailing Address - Fax:202-372-4912
Practice Address - Street 1:USCG HEADQUARTERS CLINIC
Practice Address - Street 2:2100 2ND STREET SW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20590-0001
Practice Address - Country:US
Practice Address - Phone:202-372-4100
Practice Address - Fax:202-372-4912
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other