Individual
DR. KRISTEN THEOBALD BRAIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2211 TIMBER TRL, MAPLE LEAF FAMILY AND SPORTS MEDICINE, BELLEFONTAINE, OH 43311-9036
(937) 592-3808
(937) 593-8404
Mailing address
9055 OCONNORS POINT DR, BELLE CENTER, OH 43310-9300
(937) 843-4195
(937) 593-8404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-08-1723
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2443056
—
OH
Enumeration date
10/25/2005
Last updated
04/27/2011
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