Individual
DR. CODY BRAXTON LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 WHEELING AVE, GLEN DALE, WV 26038-1660
(304) 845-3211
Mailing address
263 18TH AVE, SAN FRANCISCO, CA 94121-2314
(415) 704-4757
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25MA10897300
NJ
207P00000X
Emergency Medicine Physician
Primary
29862
WV
207P00000X
Emergency Medicine Physician
304201
NY
Other
Enumeration date
04/02/2016
Last updated
04/20/2022
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