Individual
MR. BRANDON RYAN CARNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1165 CEDAR POINT BLVD STE H, CEDAR POINT, NC 28584-1030
(252) 808-6850
Mailing address
138 SALT CREEK LN, NEWPORT, NC 28570-0270
(270) 703-0917
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-09315
NORTH CAROLINA BOARD OF MEDICAL EXAMINERS
NC
01
—
3032
SOUTH CAROLINA BOARD OF MEDICAL EXAMINERS
SC
Enumeration date
07/20/2018
Last updated
01/06/2021
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