Individual
JOHN J BRANDABUR
Active
Individual
JOHN J BRANDABUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD00023333
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030011
LABOR & INDUSTRY
WA
01
—
100005788
RAILROAD MEDICARE
—
05
—
1031699
—
WA
01
—
806364300
IDAHO MEDICAID
WA
01
—
8890442
MEDICARE PTAN - SNO CO
WA
01
—
BR7060
BLUE SHIELD
WA
01
—
MD336WA
ALASKA MEDICAID
WA
01
—
US0818959
AETNA/USHC PCP
WA
01
—
US4217189
AETNA/USHC PCP
WA
Enumeration date
07/05/2006
Last updated
02/10/2023
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