Individual
MARY-MARGARET BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MHSA
Contact information
Practice address
5301 E. HURON RIVER DR., YPSILANTI, MI 48197
(734) 712-7017
(734) 712-2844
Mailing address
PO BOX 0446 LOBBY J, 24 FRANK LLOYD WRIGHT DR., ANN ARBOR, MI 48106
(734) 712-2808
(734) 712-2844
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301071125
MI
2086S0102X
Surgical Critical Care Physician
Primary
4301071125
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
469496610
—
MI
01
—
700H262310
BLUE CROSS-BLUE CROSS
—
01
—
MB071125
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
12/18/2006
Last updated
07/21/2022
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