Doctor Name: | DEMETRIUS BRAXTON |
NPI Number: | 1508041286 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 9703 Starboard Ct Cheltenham, MD - 206231357 |
Business Phone Number: | 2024313880 |
Business Fax Number: | 3017829769 |
Mailing Address: | Po Box 582, CHELTENHAM |
State: | MD |
Postal Code: | 206230582 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/31/2007 |
NPI Last Update Date: | 12/31/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225000000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Orthotic Fitter |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the management of fitting prefabricated orthoses. |