Individual provider · NPI-1
Brandon John Parker, D.O.
Emergency Medicine · Lakewood, OH
NPI number1962609164
StatusActive
Last updated in NPPESSep 30, 2011
Details
- NPI
- 1962609164
- Entity type
- Individual (NPI-1)
- Name
- Brandon John Parker
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 29, 2007
- Last updated
- Sep 30, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 34010016 | OH | Yes |
| 207P00000X | Emergency Medicine | 262845 | NY |
Practice location
14519 Detroit AveLakewood, OH 44107-4316
Phone 216-521-4200
Mailing address
2880 N Bay Dr Apt N13Westlake, OH 44145-4477
Phone 716-479-5762
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