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Individual
PETER A. BRENNER
Active
Individual
PETER A. BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
7125
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071255
—
SC
01
—
4556601
AETNA
SC
01
—
57-1004971003
BCBS OF SC
SC
Enumeration date
06/06/2006
Last updated
01/31/2008
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