Individual
BRENDAN LEE SHEVCHIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
900 ROUND VALLEY DR STE 100, PARK CITY, UT 84060-7552
(435) 655-6600
(435) 655-2388
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00001
KY
363A00000X
Physician Assistant
14276118-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100933610
—
KY
Enumeration date
07/14/2020
Last updated
04/28/2026
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