Provider Demographics
NPI:1750432753
Name:JEAN B BRAUN, M.D.
Entity type:Organization
Organization Name:JEAN B BRAUN, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-439-2574
Mailing Address - Street 1:30 MONTVIEW ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2831
Mailing Address - Country:US
Mailing Address - Phone:724-437-1049
Mailing Address - Fax:724-439-4533
Practice Address - Street 1:105 BIERER LN
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3117
Practice Address - Country:US
Practice Address - Phone:724-439-2574
Practice Address - Fax:724-439-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012675E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA633022OtherGROUP NUMBER