Individual
BRANDON ELLIS BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
131 MILLER ST, WINSTON SALEM, NC 27103-2508
(336) 716-8200
(336) 716-9841
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-15658
NC
363AS0400X
Surgical Physician Assistant
001015658
NC
Other
Enumeration date
08/21/2025
Last updated
02/26/2026
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