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NPI Code Detail

MEDICARE: DR. BARI MICHELE BRANDT M.D.

MEDICARE: DR. BARI MICHELE BRANDT M.D.
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
1207W00000XOphthalmology PhysicianMD052464LPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1180033719OTHERPARAILROAD MEDICARE

General Provider Information

NPI Number : 1972504017
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARI MICHELE BRANDT M.D.
Provider Business Mailing Address
First Line : 56 W EAGLE RD
Second Line :
City : HAVERTOWN
State : PA
Zip : 19083-1447
Country : US
Telephone Number : 610-449-4336
Fax Number : 610-446-1735
Provider Business Practice Location Address
First Line : 1175 LANCASTER AVE
Second Line :
City : BERWYN
State : PA
Zip : 19312-1297
Country : US
Telephone Number : 610-384-9100
Fax Number : 610-384-3937
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 01/29/2021

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