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General NPI Number Information
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NPI Number | 1285336933
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Entity Type | Individual
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Provider Name | BRANDON MICHAEL FELTZ PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 7701 26 MILE RD
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City | WASHINGTON
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State | MI
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Zip | 48094-2804
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Country | US
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Telephone | 586-935-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 299 BROOK DR
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City | ROMEO
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State | MI
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Zip | 48065-5016
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Country | US
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Telephone | 248-404-8748
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1198793
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601012447
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License Number State | MI
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