Provider Demographics
NPI:1205727088
Name:BRAUN, RICHARD E (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:BRAUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95380 BENTGRASS CT
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-0028
Mailing Address - Country:US
Mailing Address - Phone:913-515-9474
Mailing Address - Fax:
Practice Address - Street 1:95380 BENTGRASS CT
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-0028
Practice Address - Country:US
Practice Address - Phone:913-515-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01037195207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine