Provider Demographics
NPI:1093717985
Name:HUNTER, BRANDEN S (MD)
Entity Type:Individual
Prefix:
First Name:BRANDEN
Middle Name:S
Last Name:HUNTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 STEPHENSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5969
Mailing Address - Country:US
Mailing Address - Phone:912-354-9447
Mailing Address - Fax:912-303-9246
Practice Address - Street 1:519 STEPHENSON AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5969
Practice Address - Country:US
Practice Address - Phone:912-354-9447
Practice Address - Fax:912-303-9246
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056081207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA238801370AMedicaid
GA238801370AMedicaid
GA10BDHJGMedicare ID - Type Unspecified