Individual
DR. BRANDON S CHISM
Active
Individual
DR. BRANDON S CHISM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35183
AZ
207RC0000X
Cardiovascular Disease Physician
Primary
E-4651
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090498
—
AZ
01
—
E-4651
STATE MEDICAL LICENSE
AR
01
—
P00381947
RAILROAD MEDICARE
AZ
Enumeration date
04/26/2006
Last updated
06/28/2012
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