Individual
MARY C BRANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 BRICKHILL AVE, SOUTH PORTLAND, ME 04106-1999
(207) 761-1502
(207) 774-2015
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
MD12242
ME
207VG0400X
Gynecology Physician
MD12242
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000767
ANTHEM
ME
01
—
1040667
AETNA
ME
01
—
160028955
GBA PALMETTO/RR MEDICARE
ME
05
—
30003368
—
NH
05
—
324350099
—
ME
01
—
M9420
CIGNA
ME
Enumeration date
10/31/2005
Last updated
10/25/2013
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