Individual
SHAWN BRANDENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-6509
(218) 898-5490
Mailing address
26901 BEAUMONT BLVD # 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1952
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
4301099089
MI
2085R0202X
Diagnostic Radiology Physician
Primary
4301099089
MI
Other
Enumeration date
07/05/2011
Last updated
07/28/2022
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