Provider Demographics
NPI:1932688967
Name:MONAGHAN, BRENDAN PATRICK OAKES (PA-C)
Entity Type:Individual
Prefix:MR
First Name:BRENDAN
Middle Name:PATRICK OAKES
Last Name:MONAGHAN
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 VEST MILL CIR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2943
Practice Address - Country:US
Practice Address - Phone:336-718-7800
Practice Address - Fax:336-718-7900
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-08348363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant