THOMAS J BRAZA (NPI# 1699883124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699883124 |
| Entity Type | Individual |
| Full Name | THOMAS J BRAZA |
| Credential | MD |
| Practice Address |
1717 Shipyard Blvd Suite 100 Wilmington NC 28403-8023 |
| Practice Telephone | 9107945355 |
| Practice Fax Number | 9107945358 |
| Mailing Telephone | (910) 794-5355 |
| Mailing Fax Number | 9107945358 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2017-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
2012-00516 | NC | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
046046 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000212917A | 05 | |
| NC | CAQH | 11182034 | 01 |
| Street Address |
1717 SHIPYARD BLVD SUITE 100 |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-8023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649274614 | Joseph F Huppmann | Dermatology | 1717 Shipyard Blvd, Suite 100, Wilmington, NC 28403 | 2005-06-08 |
| 1225636947 | Samantha Marie Dubay | Physician Assistant | 1717 Shipyard Blvd, Wilmington, NC 28403-8023 | 2020-10-14 |
| 1659889780 | Rhonda Harrelson | Radiologic Technologist | 1717 Shipyard Blvd, Wilmington, NC 28403-8023 | 2018-01-10 |
| 1083129050 | Jennifer Walker | Specialist/Technologist | 1717 Shipyard Blvd, Wilmington, NC 28403-8023 | 2017-12-12 |
| 1063927036 | Mariah Jacobs | Radiologic Technologist | 1717 Shipyard Blvd, Wilmington, NC 28403-8023 | 2017-12-12 |
| 1841705811 | Jennifer Hester | Radiologic Technologist | 1717 Shipyard Blvd, Wilmington, NC 28403-8023 | 2017-12-12 |
| 1346607066 | Summit Cosmetic Surgery Center | Specialist | 1717 Shipyard Blvd, Suite 100, Wilmington, NC 28403-8023 | 2016-01-26 |
| 1114300027 | Amber L. Smith | Radiologic Technologist | 1717 Shipyard Blvd, Suite 350, Wilmington, NC 28403 | 2015-07-09 |
| 1942694302 | Cynthia Markley Caster | Radiologic Technologist | 1717 Shipyard Blvd, #350, Wilmington, NC 28403 | 2015-03-24 |
| 1851685010 | Shoreline Physical Therapy, LLC | Physical Therapist | 1717 Shipyard Blvd, Suite 320, Wilmington, NC 28403-8023 | 2011-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
| 1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
| 1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
| 1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
| 1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
| 1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
| Find all providers in zip 28403 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831330893 | Landon Everett Stigall | Dermatology | 6752 Rock Spring Rd Ste 201, Wilmington, NC 28405 | 2009-03-20 |
| 1437130523 | Greg Edwin Viehman | Dermatology | 710 Military Cutoff Rd, Suite 200, Wilmington, NC 28405-2375 | 2005-11-07 |
| 1245578921 | Dermone of North Carolina Pa | Dermatology | 1099 Medical Center Dr, Wilmington, NC 28401-7346 | 2013-01-30 |
| 1568602969 | Delaware Valley Dermatology Group LLC | Dermatology | 3411 Silverside Rd, Suite 107; Webster Building, Wilmington, DE 19810-4812 | 2009-02-24 |
| 1235197997 | Michael L Saruk | Dermatology | 3411 Silverside Rd, Suite 107; Webster Building, Wilmington, DE 19810-4812 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942713052 | Vieta Dermatology, Pllc | Dermatology | 289 Olmsted Blvd Ste 5, Pinehurst, NC 28374-8730 | 2017-11-10 |
| 1245751403 | Bluewater Dermatology and Skin Cancer Center Pa | Dermatology | 814 Spivey Rd, Whiteville, NC 28472-8736 | 2017-06-28 |
| 1780772541 | Jenny L. Stone | Dermatology | 203 Mocksville Ave Ste B, Salisbury, NC 28144-3360 | 2006-10-10 |
| 1528035722 | Marc Ronald Carruth | Dermatology | 2615 E 7th St, Charlotte, NC 28204-4376 | 2006-03-07 |
| 1215902663 | Frederick Walter Gourdin | Dermatology | 78 Long Shoals Rd, Arden, NC 28704-7782 | 2006-02-21 |
| 1508846403 | Rajat Varma | Dermatology | 410 Market St Ste 400, Unc Dept of Dermatology, Chapel Hill, NC 27516-4061 | 2006-01-18 |
| 1598759482 | Eastern Dermatology, P.a. | Dermatology | 420 Spring Forest Rd, Greenville, NC 27834-7244 | 2005-09-07 |
| 1285636076 | Charles S Johnson | Dermatology | 315 19th St Se, Hickory, NC 28602-4230 | 2005-08-11 |
| 1134123847 | Audrey F Echt | Dermatology | 10931 Raven Ridge Rd, Ste 101, Raleigh, NC 27614-6499 | 2005-06-09 |
| 1366086597 | Pc Dermatology Pllc | Dermatology | 118 Gateway Blvd Ste A, Mooresville, NC 28117-6542 | 2019-10-31 |
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| City | WILMINGTON |
| Zip Code | 28403 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.