MEDICARE: DR. DUANE T BRANDAU D.O. PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	31741	KS

General Provider Information

NPI Number	:	1316990385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUANE T BRANDAU D.O. PHD

Provider Business Mailing Address
First Line	:	7117 MCCOY ST
Second Line	:
City	:	SHAWNEE
State	:	KS
Zip	:	66227-2641
Country	:	US
Telephone Number	:	913-371-9966
Fax Number	:	913-371-1936

Provider Business Practice Location Address
First Line	:	636 MINNESOTA AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66101-2806
Country	:	US
Telephone Number	:	913-371-9966
Fax Number	:	913-371-1936

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	07/08/2007

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