Individual
DENISE D. BRATHWAITE
Active
Individual
DENISE D. BRATHWAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G58680
CA
208VP0000X
Pain Medicine Physician
G58680
CA
208VP0014X
Interventional Pain Medicine Physician
G58680
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G586800
BLUE SHIELD
CA
Enumeration date
06/10/2006
Last updated
06/02/2015
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