Provider Demographics
NPI:1760214134
Name:MCGREW, BRANDON HEATH (CRNA)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:HEATH
Last Name:MCGREW
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571-3262
Mailing Address - Country:US
Mailing Address - Phone:251-680-9069
Mailing Address - Fax:
Practice Address - Street 1:2451 UNIVERSITY HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2300
Practice Address - Country:US
Practice Address - Phone:251-471-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-157580367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered