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Individual

RONALD P BRENNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
110 N MAIN ST, GREENVILLE, PA 16125-1726
(724) 588-2100
Mailing address
18 LIMESTONE STREET, SUITE 222, SPRINGFIELD, OH 45502
(937) 323-5400

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD040424E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000354036
BLUE CROSS BLUE SHIELD
OH
05
0019105660007
PA
05
0701315
OH
01
1402764
BLUE CROSS BLUE SHIELD
PA
Enumeration date
02/14/2006
Last updated
10/15/2009
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