Healthcare Provider Details

I. General information

NPI: 1972433852
Provider Name (Legal Business Name): MICHAEL BRANDOW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 S WASHINGTON AVE STE 310
SAGINAW MI
48607-1215
US

IV. Provider business mailing address

1818 KLOHA RD
BAY CITY MI
48706-9327
US

V. Phone/Fax

Practice location:
  • Phone: 989-793-4790
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851121931
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: