Healthcare Provider Details

I. General information

NPI: 1578863684
Provider Name (Legal Business Name): SCOTT A. BRANDT, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2010
Last Update Date: 10/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8227 S. HOLLY ST.
CENTENNIAL CO
80122
US

IV. Provider business mailing address

7447 E. BERRY AVE. SUITE 150
GREENWOOD VILLAGE CO
80111
US

V. Phone/Fax

Practice location:
  • Phone: 303-689-2300
  • Fax:
Mailing address:
  • Phone: 303-689-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number36941
License Number StateCO

VIII. Authorized Official

Name: CHRIS DOOLEY
Title or Position: ADMINISTARTOR
Credential:
Phone: 303-689-2300