Individual
BRANDON PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1813 ASHLAND AVE, SHEBOYGAN, WI 53081-6125
(920) 458-4010
Mailing address
1813 ASHLAND AVE, SHEBOYGAN, WI 53081-6125
(920) 458-4010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
64978-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2014
Last updated
07/21/2022
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