Provider Demographics
NPI:1306931027
Name:BRAUER, JEFFREY E (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:E
Last Name:BRAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 REDLAND CT
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3290
Mailing Address - Country:US
Mailing Address - Phone:410-494-7921
Mailing Address - Fax:410-902-8247
Practice Address - Street 1:1838 GREENE TREE RD
Practice Address - Street 2:420
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-6391
Practice Address - Country:US
Practice Address - Phone:410-484-9595
Practice Address - Fax:410-484-5139
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052302207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
294438OtherMAMSI
1898751OtherUNITED HEALTHCARE
MD75845501 420AOtherBLUE SHIELD
MD0019 E554OtherBLUE CHOICE FEP
4800350OtherUNITED HEALTHCARE MCO
290012457OtherRAILROAD MEDICARE
G96379Medicare UPIN
294438OtherMAMSI