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NPI Code Detail

MEDICARE: LANDRY & BRANDES MD'S PLC

MEDICARE: LANDRY & BRANDES MD'S PLC
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
1207R00000XInternal Medicine PhysicianVT

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 : 1699789693
Entity Type Code : Organization
Provider Name (Legal Business Name) : LANDRY & BRANDES MD'S PLC
Provider Business Mailing Address
First Line : 1205 NORTH AVE
Second Line :
City : BURLINGTON
State : VT
Zip : 05408-2751
Country : US
Telephone Number : 802-860-3934
Fax Number : 802-865-7616
Provider Business Practice Location Address
First Line : 1205 NORTH AVE
Second Line :
City : BURLINGTON
State : VT
Zip : 05408-2751
Country : US
Telephone Number : 802-860-3934
Fax Number : 802-865-7616
Authorized Official
Title or Position : OFFICE MANAGER
Name : MJ (MARY JANE) HYDUKE
Credential :
Telephone Number : 802-860-3934
Provider Enumeration Date : 07/28/2006
Last Update Date : 06/10/2010

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Directions to “LANDRY & BRANDES MD'S PLC ” Practice Location

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