Individual
DR. CECILIA MARGARET BRENNECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 N CAROLINE ST, BALTIMORE, MD 21287-0006
(410) 583-2702
Mailing address
PO BOX 64358, BALTIMORE, MD 21264-4358
(410) 583-2702
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0034904
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2849
B/C B/S
DC
05
—
445471500
—
MD
01
—
J062
B/C B/S
MD
01
—
KA80
B/C B/S
MD
Enumeration date
02/01/2006
Last updated
02/04/2013
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