Individual
SUSAN JEAN BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5026 PETERS CREEK PKWY, WINSTON SALEM, NC 27127-7276
(352) 442-3112
Mailing address
5026 PETERS CREEK PKWY, WINSTON SALEM, NC 27127-7276
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME87372
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME87372
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71376
BLUE CROSS BLUE SHIELD
FL
01
—
71376W
RAILROAD MEDICARE
FL
Enumeration date
05/18/2006
Last updated
12/28/2007
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