Individual
DR. BRANDON MICAH BREVIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
302 W IDAHO ST, BOISE, ID 83702-6039
(208) 994-4962
(888) 913-3862
Mailing address
2032 E SIDEWINDER DR, MERIDIAN, ID 83646-5867
(208) 488-8408
(888) 913-3862
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
11-6037195
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-6037195
GERALD TEPLITZ, DO
NY
Enumeration date
05/25/2007
Last updated
01/06/2016
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