Provider Demographics
NPI:1467730143
Name:WELSH, BRANDON (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:WELSH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5432 PARK PL
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424-1600
Mailing Address - Country:US
Mailing Address - Phone:651-292-2000
Mailing Address - Fax:952-837-9701
Practice Address - Street 1:5432 PARK PL
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55424-1600
Practice Address - Country:US
Practice Address - Phone:612-236-3856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI653962085R0202X
MN652282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology