Basic Information
| Provider Information | |||||||||
| NPI: | 1891766226 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRAUDE | ||||||||
| FirstName: | DARREN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1650 UNIVERSITY BLVD NE | ||||||||
| Address2: | SUITE 116 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871021726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052728950 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2211 LOMAS BLVD NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871062745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052728950 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 2001-19 | NM | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | B8413 | 05 | NM | MEDICAID | 201027588 | 01 | NM | PRESBYTERIAN HEALTH/SALUD | OTHER | P00165569 | 01 | RAILROAD MEDICARE | OTHER | PROVP11405 | 01 | NM | MOLINA | OTHER | 85031326887301A173 | 01 | CHAMPUS | OTHER | 10001002 | 01 | NM | LOVELACE HEALTH/SALUD | OTHER |