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Export Provider Record NPI 1366731838
Brandon Robert ManciniM.D.
Active
NPI Number1366731838
NPI TypeNPI-1 Individual
Provider Details
NPI1366731838
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2011-04-05
Last Updated2022-04-21
Mailing Address109 Michigan St Nw Ste 200
Grand Rapids, MI 49503-2302
United States
Phone: (616) 330-2522
📍 View Map
Primary Practice Address109 Michigan St Nw Ste 200
Grand Rapids, MI 49503-2302
United States
Phone: (616) 330-2522
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes2085R0001XMI4301110708
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About NPI 1366731838

Brandon Robert Mancini M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1366731838. The provider is located in Grand Rapids, MI. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2011-04-05. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1366731838?

NPI 1366731838 belongs to Brandon Robert Mancini M.D. in Grand Rapids, MI. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1366731838 active?

The current status of NPI 1366731838 in the NPPES registry is Active. The record was last updated on 2022-04-21.

What specialty is NPI 1366731838?

The taxonomy for NPI 1366731838 can be viewed in the Taxonomy section above. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1366731838?

You can verify NPI 1366731838 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1366731838?

The primary practice address on file for NPI 1366731838 is 109 Michigan St Nw Ste 200, Grand Rapids, MI 49503-2302. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1366731838 issued?

NPI 1366731838 was first issued (enumerated) on 2011-04-05. The NPPES record was last updated on 2022-04-21.

Practice Location Map

Brandon Robert Mancini is located at 109 Michigan St Nw Ste 200, Grand Rapids, MI. Use the map below to find directions or verify the practice location.

📍 109 Michigan St Nw Ste 200, Grand Rapids, MI 49503-2302  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Brandon Robert Mancini. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1366731838. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
2085R0001X4301110708MI
Data Verified from CMS NPPES Last synced: 2026-08-18 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162