Individual
BRANDON SCOTT RANDLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
27 PARK ST, HYANNIS, MA 02601-5230
(508) 862-5891
(508) 862-7316
Mailing address
27 PARK ST, MEDICAL STAFF OFFICE, HYANNIS, MA 02601-5230
(508) 862-5891
(508) 862-7316
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
257180
MA
207R00000X
Internal Medicine Physician
OS014196
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007278000
MEDICAID TPI GROUP
PA
01
—
597586
MEDICARE TPI GROUP
PA
01
—
CD4829
RAILROAD MEDICARE TPI GROUP
PA
Enumeration date
02/16/2008
Last updated
05/02/2014
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