Provider Demographics
NPI:1811191877
Name:REYNOLDS, BRANDIE ANDREWS (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANDIE
Middle Name:ANDREWS
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BRANDIE
Other - Middle Name:NICOLE
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 603898
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3898
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:953 SOUTH PAMPLICO HWY
Practice Address - Street 2:
Practice Address - City:PAMPLICO
Practice Address - State:SC
Practice Address - Zip Code:29583
Practice Address - Country:US
Practice Address - Phone:843-493-5252
Practice Address - Fax:843-493-2372
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28106207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty