Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Brandon Justin Fazalare, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1609565860

Dr. Brandon Justin Fazalare, MD is a Student in an Organized Health Care Education/Training Program in Johnson City, Tennessee. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Johnson City, TN
Fax: (423) 439-7219

No coordinates on file. Search this address in Google Maps

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1609565860
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 3, 2023
Last updated in NPPESMay 3, 2023
Certification dateMarch 28, 2023

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