IndividualActive
Brandon Fairless, M.D.
NPI 1659802502 · Pediatric Nephrology Physician · Philadelphia, PA
Provider details
- NPI number
- 1659802502
- Entity type
- Individual
- Primary specialty
- Pediatric Nephrology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- MD486184 (PA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Student, Health Care
Practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone: (215) 590-2449
Approximate (ZIP-level) locationGet directions
Mailing address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Registry dates
- Enumerated
- 2017-03-22
- Last updated
- 2025-10-15
- Certified
- 2025-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.