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Individual

MARRI KAJFEZ BRACKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
205 PAGE RD, PINEHURST, NC 28374-8749
(910) 295-5511
(910) 420-1606
Mailing address
205 PAGE RD, PINEHURST, NC 28374-8749
(910) 295-5511

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
201500906
NC
207Q00000X
Family Medicine Physician
BP10039969
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
557995
PHYSICIAN IN TRAINING
TX
Enumeration date
05/06/2011
Last updated
01/24/2018
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