Individual
DR. THEODORE BRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5248 TIMBER RIDGE RD, M, MARIETTA, GA 30068
(404) 281-5610
(404) 252-0645
Mailing address
5248 TIMBER RIDGE RD, MARIETTA, GA 30068
(404) 281-5610
(404) 252-0645
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
028730
GA
2086S0120X
Pediatric Surgery Physician
Primary
28730
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000325773A
—
GA
Enumeration date
07/18/2005
Last updated
07/21/2022
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