DR. BRANDON M WACHAL M.D. NPI 1710366018

NPI Information

NPI: 1710366018
Provider Name: DR. BRANDON M WACHAL, M.D.
Classification: Otolaryngology - 207YS0123X
Entity Type: Individual

Specialization: Facial Plastic Surgery

PECOS Registration: Yes

Address:
600 RIDGELY AVE STE 110
ANNAPOLIS, MD
ZIP 21401
Phone: (410) 573-9191
Get Directions

DR. Brandon M Wachal, M.D. is a facial plastic surgery otolaryngology in Annapolis, MD with 9 years of experience. The provider is an otolaryngologist who specializes in facial plastic surgery. DR. Brandon M Wachal, M.D. NPI is 1710366018. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduation Year:2015

The provider's business location address is:

600 RIDGELY AVE STE 110
ANNAPOLIS, MD
ZIP 21401-082
Phone: (410) 573-9191
Fax: (410) 573-5910

The NPI 1710366018 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/20/2015 and was last updated on 10/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Y00000X	Otolaryngology		D0091646	MARYLAND	No
2	207Y00000X	Otolaryngology		7401	NEBRASKA	No
3	207YX0007X	Otolaryngology	Plastic Surgery within the Head & Neck	D0091646	MARYLAND	No
4	207YS0123X	Otolaryngology	Facial Plastic Surgery	D0091646	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4695852	OTHER	MARYLAND	AETNA
2	D0091646	OTHER	MARYLAND	MARYLAND LICENSE
3	FN66-0003	OTHER	MARYLAND	CAREFIRST BCBS
4	219423600	MEDICAID	MARYLAND
5	7401	OTHER	NEBRASKA	TEP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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