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General NPI Number Information
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NPI Number | 1942552401
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Entity Type | Individual
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Provider Name | SAMUEL I BRANDT M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/09/2012
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 5034 BUR OAK LN
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City | PARKER
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State | CO
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Zip | 80134-5448
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Country | US
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Telephone | 484-678-7344
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Fax |
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Provider Business Mailing Address
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Address Line | 5034 BUR OAK LN
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City | PARKER
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State | CO
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Zip | 80134-5448
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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 | 26496
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101046456
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD069983L
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License Number State | PA
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