Individual
DR. NATHAN EVAN BRANDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4491
(765) 502-4023
Mailing address
PO BOX 78838, DETROIT, MI 48278-0838
(317) 528-4800
(317) 865-8194
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01070558A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201072740
—
IN
Enumeration date
06/01/2009
Last updated
10/20/2023
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