Provider Demographics
NPI:1720278948
Name:ALFREDO J BRAND MD PA
Entity Type:Organization
Organization Name:ALFREDO J BRAND MD PA
Other - Org Name:CAROLINA DERMATOLOGY OF HILTON HEAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:JORGE
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-689-5002
Mailing Address - Street 1:25 HOSPITAL CTR COMMON
Mailing Address - Street 2:STE 200
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926
Mailing Address - Country:US
Mailing Address - Phone:843-689-5002
Mailing Address - Fax:843-689-3690
Practice Address - Street 1:25 HOSPITAL CTR COMMON
Practice Address - Street 2:STE 200
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926
Practice Address - Country:US
Practice Address - Phone:843-689-5002
Practice Address - Fax:843-689-3690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15685 SC207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C10289Medicare UPIN
4741Medicare PIN