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Individual
BRANDON ROGER SICK
Active
Individual
BRANDON ROGER SICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17450
SC
207Q00000X
Family Medicine Physician
2006-00021
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13955
BLUE CROSS BLUE SHIELD
NC
01
—
P00243983
RAILROAD MEDICARE
—
05
—
T13660
—
SC
Enumeration date
07/16/2006
Last updated
06/24/2013
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