Provider Demographics
NPI:1912553975
Name:DAPPER, BRANDON JOSEPH (SOIDC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:JOSEPH
Last Name:DAPPER
Suffix:
Gender:M
Credentials:SOIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC BOX 20138, CAMP LEJEUNE, NC
Mailing Address - Street 2:2D RECONNAISSANCE BATTALION, 2D MARINE DIVISION
Mailing Address - City:FPO
Mailing Address - State:AA
Mailing Address - Zip Code:28542-0138
Mailing Address - Country:US
Mailing Address - Phone:910-440-7703
Mailing Address - Fax:
Practice Address - Street 1:CAMP LEJEUNE, NC
Practice Address - Street 2:2D RECONNAISSANCE BATTALION BATTALION AID STATION
Practice Address - City:FPO
Practice Address - State:AA
Practice Address - Zip Code:28542-0138
Practice Address - Country:US
Practice Address - Phone:910-440-7703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman