Individual
STACIA E. BRANDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
25500 POINT LOOKOUT RD, LEONARDTOWN, MD 20650-2015
(240) 826-7550
Mailing address
9901 MEDICAL CENTER DR, ROCKVILLE, MD 20850-3357
(240) 826-7550
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0005910
MD
363A00000X
Physician Assistant
PA21790
CA
Other
Enumeration date
09/01/2011
Last updated
12/11/2018
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