Basic Information
Provider Information
NPI: 1285690479
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EARP
FirstName: BRANDON
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 375 BOYLSTON ST
Address2:  
City: BROOKLINE
State: MA
PostalCode: 024456007
CountryCode: US
TelephoneNumber: 8573070896
FaxNumber:  
Practice Location
Address1: 75 FRANCIS STREET
Address2: BRIGHAM AND WOMEN'S HOSPITAL DEPT OF ORTHOPEDIC SURGERY
City: BOSTON
State: MA
PostalCode: 02115
CountryCode: US
TelephoneNumber: 6177325249
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/25/2006
LastUpdateDate: 04/07/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0106X220991MAY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
207X00000X220991MAN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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