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General NPI Number Information
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NPI Number | 1699064196
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Entity Type | Individual
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Provider Name | BRANDON PHILIP OLIVIERI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 180 LOTAWATAH DR
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City | BURNSVILLE
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State | NC
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Zip | 28714-5038
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Country | US
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Telephone | 833-228-6889
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 N 102ND ST STE 201
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City | OMAHA
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State | NE
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Zip | 68114-2122
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Country | US
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Telephone | 833-228-6889
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Fax | 877-853-0376
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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 | MC-255
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License Number State | GU
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD-53573
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License Number State | IA
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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 | ME131503
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 202302765
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License Number State | NC
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