Healthcare Provider Details

I. General information

NPI: 1730407040
Provider Name (Legal Business Name): BRANDON CHRISTOPHER CAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2704 HENRY ST
GREENSBORO NC
27405-3633
US

IV. Provider business mailing address

600 GRESHAM DR STE 8620
NORFOLK VA
23507-1904
US

V. Phone/Fax

Practice location:
  • Phone: 336-663-5700
  • Fax: 336-663-5734
Mailing address:
  • Phone: 757-622-2649
  • Fax: 757-961-6440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number2017-00507
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: