Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 12427 | GA |
NPI | 1033119128 |
---|---|
Provider Name | Dr. Robert L Brand III |
First Address | Augusta, GA 30919-0039 |
Second Address | Augusta, GA 30909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 13/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00007917A | (05) | GA |
009601010 | (05) | AL |
0519782 | AETNA (01) | GA |
0900120 | UNITED HEALTHCARE (01) | GA |
175569 | BCBS (01) | GA |
201603825 | RAILROAD MEDICARE (01) | GA |
581327528 | COMMERICAL (01) | GA |
D39468 | (02) | GA |
G12427 | (05) | SC |