Healthcare Provider Details

I. General information

NPI: 1619936978
Provider Name (Legal Business Name): BRENDA M. BRANDON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 08/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5606 WEXFORD ROAD
BALTIMORE MD
21209
US

IV. Provider business mailing address

5606 WEXFORD ROAD
BALTIMORE MD
21209
US

V. Phone/Fax

Practice location:
  • Phone: 410-428-3322
  • Fax: 410-997-8832
Mailing address:
  • Phone: 410-428-3322
  • Fax: 410-997-8832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberD0032966
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: