MEDICARE: DR. JEFF IRA BRAND M.D.

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	208000000X	Pediatrics Physician	1821	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477535961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFF IRA BRAND M.D.

Provider Business Mailing Address
First Line	:	3340 PROVIDENCE DR STE 452
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4628
Country	:	US
Telephone Number	:	907-562-2120
Fax Number	:	907-562-6527

Provider Business Practice Location Address
First Line	:	3340 PROVIDENCE DR STE 452
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4628
Country	:	US
Telephone Number	:	907-562-2120
Fax Number	:	907-562-6527

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	07/15/2022

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