Provider Demographics
NPI:1235984303
Name:OJEDA, BRANDON SEBASTIAN
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:SEBASTIAN
Last Name:OJEDA
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 1:120 COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1801
Mailing Address - Country:US
Mailing Address - Phone:330-623-3552
Mailing Address - Fax:
Practice Address - Street 1:ERIE INDUSTRIAL PARK BLDG 360
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-9412
Practice Address - Country:US
Practice Address - Phone:419-635-2853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman