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Individual
BRUCE HOWARD BRENNAMAN
Active
Individual
BRUCE HOWARD BRENNAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
31709
GA
2086S0129X
Vascular Surgery Physician
Primary
31709
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000318117B
—
GA
01
—
000318117G
MEDICAID-OFFICE
GA
05
—
008902960
—
AL
01
—
154485
MEDICAID-OFFICE
AL
01
—
52244152-005
BCBSGA
GA
01
—
600-37660
BCBSAL
AL
Enumeration date
02/03/2006
Last updated
07/01/2014
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