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General NPI Number Information
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NPI Number | 1326626615
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Entity Type | Individual
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Provider Name | CHANDLER PARADISE BRANDENBURG MD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 159 W RAILROAD ST
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City | PEMBROKE
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State | GA
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Zip | 31321
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Country | US
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Telephone | 912-653-2897
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Fax |
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Provider Business Mailing Address
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Address Line | 4630 SUSSEX PL
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City | SAVANNAH
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State | GA
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Zip | 31405-4221
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 100176
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License Number State | GA
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