Individual
BRANDON SAM KAKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
4301109849
MI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
35098143
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366677437
—
MI
Enumeration date
05/19/2009
Last updated
07/21/2022
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