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General NPI Number Information
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NPI Number | 1225289168
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Entity Type | Individual
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Provider Name | BRANDON CARTER MCDUFFIE PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 87 MCGREGOR ST STE 2100
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City | MANCHESTER
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State | NH
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Zip | 03102-3767
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Country | US
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Telephone | 603-626-7546
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Fax | 603-626-7548
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Provider Business Mailing Address
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Address Line | 526 MAIN ST STE 302
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City | ACTON
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State | MA
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Zip | 01720-3301
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Country | US
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Telephone | 978-371-7010
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Fax | 978-371-0522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1918
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License Number State | NH
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