# EDMUND J BRENNAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1003812660
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | 28201 | AZ | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | 28201 | AZ | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | 65654 | MT | Yes |

## Other

- **Enumeration date:** 06/28/2005
- **Last updated:** 04/25/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 060057219 | RAILROAD MEDICARE | AZ |
| 01 | — | 1Z5173 | HEALTHNET | AZ |
| 01 | — | 2500514 | UNITED HEALTHCARE | AZ |
| 05 | — | 500711 | — | AZ |
| 01 | — | AZ0863440 | BLUE CROSS BLUE SHIELD | AZ |