Provider Demographics
NPI:1457125197
Name:SHOLAR, BRANDI D
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:D
Last Name:SHOLAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17200 E 10 MILE RD STE 290
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3355
Mailing Address - Country:US
Mailing Address - Phone:313-575-7778
Mailing Address - Fax:
Practice Address - Street 1:17200 E 10 MILE RD STE 290
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3355
Practice Address - Country:US
Practice Address - Phone:313-575-7778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty