Provider Demographics
NPI:1689638165
Name:BRAND, ALFREDO JORGE (MD)
Entity type:Individual
Prefix:
First Name:ALFREDO
Middle Name:JORGE
Last Name:BRAND
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2330
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-2330
Mailing Address - Country:US
Mailing Address - Phone:843-837-4400
Mailing Address - Fax:843-837-4440
Practice Address - Street 1:1813 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:PORT ROYAL
Practice Address - State:SC
Practice Address - Zip Code:29935-2014
Practice Address - Country:US
Practice Address - Phone:843-837-4400
Practice Address - Fax:843-837-4440
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15685207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCBB2810340OtherDEA
C10289Medicare UPIN