Provider Demographics
NPI:1003233214
Name:ROSS, BRANDON PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:PATRICK
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:303-471-0221
Mailing Address - Fax:303-393-7144
Practice Address - Street 1:9137 RIDGELINE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129
Practice Address - Country:US
Practice Address - Phone:303-471-0221
Practice Address - Fax:303-393-7144
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0058606208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR.0058606OtherMEDICAL LICENSE