Individual
DR. TARA FAYE BRENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3024 NEW BERN AVE FL 2, RALEIGH, NC 27610-1247
(919) 350-0554
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0554
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2021-00429
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134650211
—
NC
Enumeration date
03/21/2017
Last updated
03/29/2022
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