Individual
MR. BRANDON D WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1668 MULKEY RD STE 164, AUSTELL, GA 30106-1242
(770) 948-3233
(770) 944-1537
Mailing address
1835 SAVOY DR, STE 300, ATLANTA, GA 30341-1072
(770) 948-3233
(770) 944-1537
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004217
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I971517
MEDICARE PTAN
GA
05
—
909178080G
—
GA
05
—
909178080H
—
GA
05
—
909178080I
—
GA
05
—
909178080J
—
GA
Enumeration date
06/20/2005
Last updated
08/17/2020
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