Basic Information
| Provider Information | |||||||||
| NPI: | 1154766079 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRAUNAGEL | ||||||||
| FirstName: | SHAWN | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 35100 | ||||||||
| Address2: | BILLINGS CLINIC | ||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59107 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 801 N 29TH ST | ||||||||
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| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591010905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062382500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2013 | ||||||||
| LastUpdateDate: | 06/15/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | MED-POD-LIC-49524 | MT | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
No ID Information.