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NPI Code Detail

MEDICARE: BRANDUS MAGEE BS

MEDICARE: BRANDUS MAGEE BS
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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497221014
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDUS MAGEE BS
Provider Business Mailing Address
First Line : 350 GATEWAY DR
Second Line :
City : SLIDELL
State : LA
Zip : 70461-5589
Country : US
Telephone Number : 985-707-1410
Fax Number : 985-707-1415
Provider Business Practice Location Address
First Line : 350 GATEWAY DR
Second Line :
City : SLIDELL
State : LA
Zip : 70461-5589
Country : US
Telephone Number : 985-707-1410
Fax Number : 985-707-1415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2018
Last Update Date : 03/30/2020

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