Healthcare Provider Details

I. General information

NPI: 1730472382
Provider Name (Legal Business Name): JOHN CONRAD BRANDT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 06/08/2020
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 VANDERBILT PARK DR
ASHEVILLE NC
28803-1700
US

IV. Provider business mailing address

5 VANDERBILT PARK DR
ASHEVILLE NC
28803-1700
US

V. Phone/Fax

Practice location:
  • Phone: 828-274-6000
  • Fax:
Mailing address:
  • Phone: 828-274-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTRN16128
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME119948
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME119948
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number2020-00405
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: