Individual
BRANDON TIMOTHY PACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5 GARRETT AVE, LA PLATA, MD 20646-5960
(301) 609-4444
Mailing address
21692 POTOMAC VIEW DR, LEONARDTOWN, MD 20650-2134
(212) 920-9559
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R233658
MD
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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