Individual
TODD A BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
640 S. STATE STREET, MAIL CODE 3055, DOVER, DE 19901-3530
(302) 480-1688
(302) 480-9807
Mailing address
540 S GOVERNORS AVE, DOVER, DE 19904-3530
(302) 744-7980
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C50000678
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C50000678
DE LICENSE
DE
01
—
MA053873
PENNSYLVANIA PA LICENSE
PA
Enumeration date
08/26/2009
Last updated
10/01/2021
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