Provider Demographics
NPI:1174766620
Name:SNEAD, BRANDON L (MD)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:L
Last Name:SNEAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6765 W CHARLESTON BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-2001
Mailing Address - Country:US
Mailing Address - Phone:702-518-5774
Mailing Address - Fax:702-852-0890
Practice Address - Street 1:6765 W CHARLESTON BLVD STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-518-5774
Practice Address - Fax:702-852-0890
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2024-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV154282081S0010X, 204C00000X, 2081P0004X, 204D00000X, 208100000X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1376795823OtherGROUP NPI
NVV111833OtherPTAN