Provider Demographics
NPI:1669798419
Name:OBERWEIS, BRANDON SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:SCOTT
Last Name:OBERWEIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 CRANBURY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4093
Mailing Address - Country:US
Mailing Address - Phone:732-390-3333
Mailing Address - Fax:732-390-9244
Practice Address - Street 1:593 CRANBURY RD STE 2
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4093
Practice Address - Country:US
Practice Address - Phone:732-390-3333
Practice Address - Fax:732-390-9244
Is Sole Proprietor?:No
Enumeration Date:2010-04-18
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10003600207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ586029OtherMEDICARE
NJ0570842Medicaid