Healthcare Provider Details

I. General information

NPI: 1639222425
Provider Name (Legal Business Name): MICHAEL D BRANDNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 LAKE OTIS PKWY SUITE #100
ANCHORAGE AK
99508
US

IV. Provider business mailing address

PO BOX 232711
ANCHORAGE AK
99523-2711
US

V. Phone/Fax

Practice location:
  • Phone: 907-272-9991
  • Fax: 907-279-9991
Mailing address:
  • Phone: 907-272-9991
  • Fax: 907-279-9991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number3478
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number3478
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: