Provider Demographics
NPI:1760417158
Name:BRANDT, JOANNA D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:D
Last Name:BRANDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6535 N CHARLES ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-5826
Mailing Address - Country:US
Mailing Address - Phone:410-938-5252
Mailing Address - Fax:410-938-5250
Practice Address - Street 1:6535 N CHARLES ST
Practice Address - Street 2:SUITE 300
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-5826
Practice Address - Country:US
Practice Address - Phone:410-938-5252
Practice Address - Fax:410-938-5250
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00349202084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD430900600Medicaid
E23704Medicare UPIN
MD430900600Medicaid