Provider Demographics
NPI:1780397695
Name:DEAL, BRANDON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:DEAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 EDGEWAY DR APT 722
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-4264
Mailing Address - Country:US
Mailing Address - Phone:828-578-4358
Mailing Address - Fax:
Practice Address - Street 1:151 EDGEWAY DR APT 722
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-4264
Practice Address - Country:US
Practice Address - Phone:828-578-4358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist