Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 042-0006944 | VT |
NPI | 1043302979 |
---|---|
Provider Name | Dr. Richard Frank Branda |
First Address | Shelburne, VT 05482 |
Second Address | Burlington, VT 05401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005596 | (05) | VT |
00776958 | (05) | NY |
C65396 | (02) |