Individual
DR. JOHN ALAN BRANDA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, GRB 526, CLINICAL MICROBIOLOGY, BOSTON, MA 02114-2696
(617) 726-3611
(617) 726-5957
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
219811
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2039699
—
MA
01
—
468829
TUFTS HEALTH PLAN
MA
01
—
J27255
BCBS MA
MA
Enumeration date
11/21/2005
Last updated
07/08/2007
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