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General NPI Number Information
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NPI Number | 1760080865
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Entity Type | Individual
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Provider Name | BRANDON DAUL PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 1500 CENTRAL PARK COMMONS DR
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City | EAGAN
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State | MN
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Zip | 55121-8702
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Country | US
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Telephone | 651-405-3660
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Fax |
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Provider Business Mailing Address
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Address Line | 5995 LINCOLN DR APT 342
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City | EDINA
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State | MN
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Zip | 55436-6118
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Country | US
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Telephone | 952-288-5092
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 124732
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License Number State | MN
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