| Doctor Name: | MARK GILBERT BRAVERMAN |
| NPI Number: | 1164685277 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 35.123384 |
| Business Practice Address: | 350 Thomas More Pkwy Ste 280 Crestview Hills, KY - 410175465 |
| Business Phone Number: | 8594260800 |
| Business Fax Number: | 8594264140 |
| Mailing Address: | 2300 Chamber Center Dr, Ste 200 LAKESIDE PARK |
| State: | KY |
| Postal Code: | 410171686 |
| Phone Number: | 8594260800 |
| Fax Number: | 8594264140 |
| NPI Enumeration Date: | 07/08/2008 |
| NPI Last Update Date: | 03/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0000X |
| License Number: | 35.123384 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Cardiovascular Disease |
| Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |