Individual
DEREK BRAUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6644 E BAYWOOD AVE, MESA, AZ 85206-1747
(480) 981-4391
(480) 981-4624
Mailing address
PO BOX 708850, SANDY, UT 84070-8850
(866) 869-2395
(801) 352-9502
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25922
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
462284
—
AZ
01
—
77171
BCBS-CALDWELL
ID
05
—
8079511
—
ID
01
—
AZ0753310
BC/BS OF AZ
AZ
01
—
B6226
BCBS-NAMPA
ID
Enumeration date
03/27/2006
Last updated
05/13/2008
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