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NPI Code Detail

MEDICARE: MARY BRANDT MD

MEDICARE: MARY BRANDT MD
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
12086S0120XPediatric Surgery PhysicianG6705TX
22086S0120XPediatric Surgery Physician323841LA

General Provider Information

NPI Number : 1801976238
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY BRANDT MD
Provider Business Mailing Address
First Line : 1430 TULANE AVE
Second Line : # 8622
City : NEW ORLEANS
State : LA
Zip : 70112-2632
Country : US
Telephone Number : 832-822-3135
Fax Number : 832-825-3141
Provider Business Practice Location Address
First Line : 200 HENRY CLAY AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70118-5798
Country : US
Telephone Number : 504-899-9511
Fax Number : 832-825-3141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 10/02/2020

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Directions to “ MARY BRANDT MD” Practice Location

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