Provider Demographics
NPI:1588757082
Name:MICHAEL C BRAUNSTEIN M D LTD
Entity type:Organization
Organization Name:MICHAEL C BRAUNSTEIN M D LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:BRAUNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-388-1661
Mailing Address - Street 1:939 S DECATUR BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3918
Mailing Address - Country:US
Mailing Address - Phone:702-388-1661
Mailing Address - Fax:702-384-0103
Practice Address - Street 1:939 S DECATUR BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3918
Practice Address - Country:US
Practice Address - Phone:702-388-1661
Practice Address - Fax:702-384-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV38584Medicare ID - Type UnspecifiedGROUP