Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101006748 | MI |
NPI | 1285613364 |
---|---|
Provider Name | Dr. Warren L Brandes |
First Address | Farmington Hills, MI 48334-3292 |
Second Address | Madison Heights, MI 48071-5711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 25/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1285613364 | (05) | MI |
1320120 | (05) | MI |
1320149 | (05) | MI |
3429588 | (05) | MI |
E33123 | (02) | MI |
MI4989307 | MEDICARE PTAN (01) | MI |