Provider Demographics
NPI:1619936978
Name:BRANDON, BRENDA M (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:M
Last Name:BRANDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8945 GUILFORD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2659
Mailing Address - Country:US
Mailing Address - Phone:410-997-8444
Mailing Address - Fax:410-997-8832
Practice Address - Street 1:8945 GUILFORD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2659
Practice Address - Country:US
Practice Address - Phone:410-997-8444
Practice Address - Fax:410-997-8832
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0032966207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD286301400Medicaid
MD0032OtherCAREFIRST-DC
MD0032OtherCAREFIRST-DC
MD0032OtherCAREFIRST-DC
MD539P094HMedicare PIN