Individual
BRANDON J MANDERLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2700 E CENTRE AVE, PORTAGE, MI 49002-5500
(269) 286-7050
Mailing address
601 JOHN STREET, BOX 39, KALAMAZOO, MI 49007-1282
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301505916
MI
Other
Enumeration date
06/11/2019
Last updated
07/27/2022
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