Provider Demographics
NPI:1962144915
Name:BRADEN, ABIGAIL MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:MARIE
Last Name:BRADEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:MARIE
Other - Last Name:MOFFIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27100 CHARDON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1116
Mailing Address - Country:US
Mailing Address - Phone:440-516-8706
Mailing Address - Fax:
Practice Address - Street 1:27100 CHARDON RD STE 201
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1116
Practice Address - Country:US
Practice Address - Phone:440-516-8706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program