Healthcare Provider Details

I. General information

NPI: 1285336982
Provider Name (Legal Business Name): MATTIE M BRAND DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S POTOMAC ST STE 250
AURORA CO
80012-4541
US

IV. Provider business mailing address

2610 S VAUGHN WAY APT C
AURORA CO
80014-2065
US

V. Phone/Fax

Practice location:
  • Phone: 303-531-4910
  • Fax:
Mailing address:
  • Phone: 720-315-9930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0073795
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: