Individual
MR. BRANDON JAY BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3333 SILAS CREEK PKWY, EMERGENCY DEPARTMENT, WINSTON SALEM, NC 27103-3013
(336) 765-9328
(336) 768-5762
Mailing address
P.O. BOX 25477, FORSYTH EMERGENCY SERVICES P.A., WINSTON SALEM, NC 27114-5447
(336) 765-9328
(336) 768-5762
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04304
NC
Other
Enumeration date
06/25/2013
Last updated
10/29/2020
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