Provider Demographics
NPI:1053370320
Name:BRAUN, STEPHANIE MARGARET (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:MARGARET
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 1:400 WASHINGTON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4729
Mailing Address - Country:US
Mailing Address - Phone:781-380-8150
Mailing Address - Fax:
Practice Address - Street 1:400 WASHINGTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4729
Practice Address - Country:US
Practice Address - Phone:781-380-8150
Practice Address - Fax:781-380-8160
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209841207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA183784Medicaid
MAH73003Medicare UPIN
MAA34784Medicare ID - Type Unspecified