Individual
FRED K BRANDITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
751 FOREST AVE STE 400, ZANESVILLE, OH 43701-2875
(740) 586-6888
Mailing address
945 BETHESDA DR STE 200, ZANESVILLE, OH 43701-1880
(740) 454-4788
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35055322
OH
207RP1001X
Pulmonary Disease Physician
Primary
35-055322
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0669487
—
OH
01
—
0989499
GROUP MEDICAID
OH
01
—
110175445
MEDICARE RAILROAD
OH
01
—
CA1586
GROUP MEDICARE RAILROAD
—
Enumeration date
12/16/2005
Last updated
07/24/2012
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