Theodore Brand, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

28730 Issued in GA

Practice address

5248 Timber Ridge Rd
M
Marietta, GA 30068

Phone

(404) 281-5610

Fax

(404) 252-0645

NPI assigned

Jul 18, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: theodore.brand@gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pediatric, Adolescent Surgican Associates, P.C.

  • Specialist
  • Atlanta, GA
  • NPI 1164499869
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790784221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5248 TIMBER RIDGE RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30068",
            "telephone_number": "404-281-5610",
            "fax_number": "404-252-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5248 TIMBER RIDGE RD",
            "address_2": "M",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30068",
            "telephone_number": "404-281-5610",
            "fax_number": "404-252-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAND",
        "first_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "GA",
            "license": "28730",
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "GA",
            "license": "028730",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000325773A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph J Braintwain, M.D.
• Julie C.H. Brake, M.S., RD, LD
• Russell L. Branch Jr., CRNA
• Branches Senior Services LLC
• Taylor Brand, LCSW
• Alan D Brandis, PH.D.
• Erin Michele Brandow, PA
• Jaclyn Melissa Brandt, DPT
• Melida Brandt
• Jeffrey Brannan, LPC

• Pediatric Surgery Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Pediatric Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.