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NPI Code Detail

MEDICARE: BRANDON SCOTT MAINE

MEDICARE: BRANDON SCOTT MAINE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistAPRN94463WV

General Provider Information

NPI Number : 1295234482
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON SCOTT MAINE
Provider Business Mailing Address
First Line : 1111 VALLEY VIEW AVE TRLR 31
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-3684
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 MEDICAL CENTER DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26506-1200
Country : US
Telephone Number : 304-598-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2018
Last Update Date : 04/07/2026

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Directions to “ BRANDON SCOTT MAINE ” Practice Location

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