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General NPI Number Information
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NPI Number | 1790706182
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Entity Type | Individual
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Provider Name | DAVID ALLEN BRANTLEY MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 6060 PIEDMONT ROW DR S FL 6
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City | CHARLOTTE
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State | NC
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Zip | 28287
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Country | US
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Telephone | 704-489-3094
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Fax |
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Provider Business Mailing Address
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Address Line | 5960 FAIRVIEW RD STE 500
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City | CHARLOTTE
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State | NC
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Zip | 28210-3113
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Country | US
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Telephone | 704-495-6334
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Fax | 704-817-7219
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 9800197
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License Number State | NC
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