Individual
THOMAS J BRAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
144 POOLE RD STE 101, LELAND, NC 28451-9504
(910) 640-0899
(910) 256-6039
Mailing address
144 POOLE RD STE 101, LELAND, NC 28451-9504
(910) 640-0899
(910) 256-6039
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
046046
GA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
2012-00516
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000212917A
—
GA
01
—
11182034
CAQH
NC
Enumeration date
08/25/2006
Last updated
11/01/2021
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