Provider Demographics
NPI:1437545340
Name:BRAND, SAMANTHA MIRANDA (MD)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MIRANDA
Last Name:BRAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:MIRANDA
Other - Last Name:UMALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:563 WOOD NYMPH LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-5359
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:999 WATERSIDE DR STE 2525
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-3316
Practice Address - Country:US
Practice Address - Phone:202-596-8891
Practice Address - Fax:833-941-2357
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101264560207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine