Individual
BRANDON MICHAEL CUSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-2741
(352) 265-0438
Mailing address
PO BOX 100374, GAINESVILLE, FL 32610-3841
(352) 265-0438
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
04-38716
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2012
Last updated
04/05/2016
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