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General NPI Number Information
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NPI Number | 1811284680
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Entity Type | Individual
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Provider Name | BRANDON ALLEN DOSER D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 950 FRANCIS PL STE 2
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City | CLAYTON
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State | MO
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Zip | 63105-2465
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Country | US
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Telephone | 314-726-2377
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Fax |
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Provider Business Mailing Address
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Address Line | 430 IRON LANTERN DR
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City | BALLWIN
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State | MO
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Zip | 63011-2745
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Country | US
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Telephone | 636-346-1919
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2016021073
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License Number State | MO
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