Provider Demographics
NPI:1962512400
Name:BRANDON, ROCHELLE M (MD)
Entity type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:M
Last Name:BRANDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROCHELLE
Other - Middle Name:MONIQUE
Other - Last Name:BRANDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10310 MALLARD CREEK RD STE 101D
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-4563
Mailing Address - Country:US
Mailing Address - Phone:704-510-1600
Mailing Address - Fax:704-510-1601
Practice Address - Street 1:10310 MALLARD CREEK RD STE 101D
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4563
Practice Address - Country:US
Practice Address - Phone:704-510-1600
Practice Address - Fax:704-510-1601
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601242207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891237KMedicaid
NC2280087EMedicare ID - Type UnspecifiedORMAND CENTER FOR WOMEN
NC2280087BMedicare ID - Type UnspecifiedNORTHCROSS OB/GYN
NC2280087FMedicare ID - Type UnspecifiedEUOBGYN
NC891237KMedicaid
NC2280087GMedicare PIN