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NPI Code Detail

MEDICARE: DR. BRANDON ALYAS MD

MEDICARE: DR. BRANDON ALYAS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianD01922311AZ
2207Q00000XFamily Medicine Physician68953MN

General Provider Information

NPI Number : 1831621051
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRANDON ALYAS MD
Provider Business Mailing Address
First Line : 6621 W ROWEL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85083-1062
Country : US
Telephone Number : 623-570-3807
Fax Number :
Provider Business Practice Location Address
First Line : 7801 E BUSH LAKE RD STE 400
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55439-3113
Country : US
Telephone Number : 623-570-3807
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2017
Last Update Date : 12/13/2021

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