Provider Demographics
NPI:1396976759
Name:BRAUN, MARK (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:BRAUN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1001 E 3RD ST
Mailing Address - Street 2:MEDICAL SCIENCES, JORDAN HALL 104
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47405-7005
Mailing Address - Country:US
Mailing Address - Phone:812-855-8118
Mailing Address - Fax:812-855-4436
Practice Address - Street 1:1001 E 3RD ST
Practice Address - Street 2:MEDICAL SCIENCES, JORDAN HALL 104
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47405-7005
Practice Address - Country:US
Practice Address - Phone:812-855-8118
Practice Address - Fax:812-855-4436
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
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Provider Licenses
StateLicense IDTaxonomies
IN01026201A207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology