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Individual

BRADEN LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10583 W LAKE HAZEL RD, BOISE, ID 83709-6326
(208) 302-5900
(208) 302-5955
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-9342
(208) 367-5180

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-16829
ID

Other

Enumeration date
03/27/2020
Last updated
12/22/2025
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