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General NPI Number Information
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NPI Number | 1033646427
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Entity Type | Individual
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Provider Name | CASEY BRANACH MD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 1215 E MICHIGAN AVE
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City | LANSING
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State | MI
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Zip | 48912-1811
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Country | US
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Telephone | 517-364-3464
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 E MEDICAL CENTER DR UH B1 502
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City | ANN ARBOR
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State | MI
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Zip | 48109-5030
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C1-0027719
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | C1-0027719
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 4301500654
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License Number State | MI
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