Individual
ROLAND BRANDT
Active
Individual
ROLAND BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101007240
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2056305914
BCBSM PIN
MI
05
—
4127008 TYPE 11
—
MI
05
—
4127017 TYPE 11
—
MI
01
—
4518251
AETNA
MI
01
—
502919
CARE CHCS/PREF CHCS
MI
01
—
5606110001
ADMINISTAR FED DME RSC
MI
01
—
5606110003
ADMINISTAR FED DME HARTLAND
MI
01
—
C5548
MCARE
MI
Enumeration date
11/03/2005
Last updated
05/14/2008
Update your record
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