Individual
DR. ALAN STEVEN BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 CEDAR ST SE, SUITE 4600, ALBUQUERQUE, NM 87106-4917
(505) 563-6450
(505) 563-6484
Mailing address
201 CEDAR ST SE, SUITE 4600, ALBUQUERQUE, NM 87106-4917
(505) 563-6450
(505) 563-6484
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
MD2012-0882
NM
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
8123
SD
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
MD00016472
WA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
MD2012-0882
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1158609
—
WA
05
—
6301580
—
SD
01
—
G000100601
MEDICARE
WA
Enumeration date
01/21/2007
Last updated
05/13/2013
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