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NPI Code Detail

MEDICARE: MADELINE BRANDT PA-C

MEDICARE: MADELINE BRANDT PA-C
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
1363A00000XPhysician Assistant50.007575RXOH

General Provider Information

NPI Number : 1386382448
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE BRANDT PA-C
Provider Business Mailing Address
First Line : 6780 MAYFIELD RD
Second Line :
City : MAYFIELD HEIGHTS
State : OH
Zip : 44124-2203
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6780 MAYFIELD RD
Second Line :
City : MAYFIELD HEIGHTS
State : OH
Zip : 44124-2203
Country : US
Telephone Number : 330-242-1153
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2022
Last Update Date : 04/23/2026

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Directions to “ MADELINE BRANDT PA-C” Practice Location

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