Provider Demographics
NPI:1972504017
Name:BRANDT, BARI MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:BARI
Middle Name:MICHELE
Last Name:BRANDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:56 W EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-1447
Mailing Address - Country:US
Mailing Address - Phone:610-449-4336
Mailing Address - Fax:610-446-1735
Practice Address - Street 1:1175 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1297
Practice Address - Country:US
Practice Address - Phone:610-384-9100
Practice Address - Fax:610-384-3937
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2021-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD052464L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA180033719OtherRAILROAD MEDICARE
PA180033719OtherRAILROAD MEDICARE
PA678598Medicare PIN