Individual
MARC L BRAITHWAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
385 SOUTHBRIDGE ST, AUBURN, MA 01501-2498
(508) 856-9599
(508) 832-5951
Mailing address
5 NEPONSET ST FL STREET12, WORCESTER, MA 01606-2714
(508) 836-8553
(508) 832-5951
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4997
MA
152W00000X
Optometrist
DA1826
MD
152W00000X
Optometrist
OPT903
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402872400
—
MD
05
—
433061299
—
ME
Enumeration date
04/27/2006
Last updated
03/13/2019
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