Provider Demographics
NPI:1558182857
Name:NORRIS, BRANDON LEE
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:LEE
Last Name:NORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WOODWARD
Mailing Address - Street 2:5TH FL
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226
Mailing Address - Country:US
Mailing Address - Phone:313-442-3511
Mailing Address - Fax:
Practice Address - Street 1:1001 WOODWARD
Practice Address - Street 2:5TH FL
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226
Practice Address - Country:US
Practice Address - Phone:313-442-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker