Provider Demographics
NPI:1467745224
Name:ANDREW, BRANDON DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:DANIEL
Last Name:ANDREW
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 1:719 W HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6968
Mailing Address - Country:US
Mailing Address - Phone:715-832-1044
Mailing Address - Fax:715-832-0520
Practice Address - Street 1:719 W HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6968
Practice Address - Country:US
Practice Address - Phone:715-832-1044
Practice Address - Fax:715-832-0520
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT199415208600000X
WI67582-20208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery