Healthcare Provider Details

I. General information

NPI: 1356957286
Provider Name (Legal Business Name): BRANDON FILBECK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 06/19/2023
Certification Date: 06/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 E MAIN ST STE 100
MIDLAND MI
48640-5488
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-794-3200
  • Fax: 989-794-3215
Mailing address:
  • Phone: 844-832-1956
  • Fax: 989-633-5241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704304127
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: