# DEREK M BRICKNER

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

## Provider details

- **NPI number:** 1346405602
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 11895 | ND | Yes |
| 207Q00000X | Family Medicine Physician | TEP5877 | NE | — |

## Other

- **Enumeration date:** 07/25/2008
- **Last updated:** 03/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 16213 | — | ND |
| 05 | — | 47055301100 | — | NE |