# BRUCE HOWARD BRENNAMAN

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

## Provider details

- **NPI number:** 1578535563
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 31709 | GA | — |
| 2086S0129X | Vascular Surgery Physician | 31709 | GA | Yes |

## Other

- **Enumeration date:** 02/03/2006
- **Last updated:** 07/01/2014

## 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 |