Robert R. Braswell, MD

Individual provider Active NPI Psychiatry Physician · Marne, MI

NPI 1992812762 · NPPES record last updated Jan 23, 2024

Key facts

NPI
1992812762
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
4301108828 (MI)
Practice address
15146 16TH Ave # 208
Marne, MI 49435-9605
Phone
(844) 776-9651
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 86346FLMDForensic Psychiatry Physician
4301108828MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vericare of Florida, Inc. Psychiatry Past Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 6615 AK
Forensic Psychiatry Physician 2084F0202X ME 86346 FL
Psychiatry Physician 2084P0800X 4301108828 MI Yes

Addresses

Primary practice location

15146 16TH Ave # 208
Marne, MI 49435-9605

Mailing address

15146 16TH Ave
Marne, MI 49435-9605
Phone (844) 776-9651

Other providers in Marne, MI

All providers in Marne, MI · Psychiatry Physician in Michigan

Sources for this page

Verify at the official NPI Registry.