Provider Demographics
NPI:1114704079
Name:METCALF, BRANDON (PA-C)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:METCALF
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54880 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-1214
Mailing Address - Country:US
Mailing Address - Phone:586-275-9971
Mailing Address - Fax:
Practice Address - Street 1:44038 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5035
Practice Address - Country:US
Practice Address - Phone:248-335-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant