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Organization

DRS. BRENNER & MITNICK, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALAN H MITNICK M.D. (V.P/ OWNER)
(410) 922-1133
Entity
Organization

Contact information

Practice address
5400 OLD COURT RD, SUITE 105, RANDALLSTOWN, MD 21133-5100
(410) 922-1133
(410) 922-9710
Mailing address
3408 ENGLEMEADE RD, PIKESVILLE, MD 21208-1601
(410) 484-1416

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N/A

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
383081100
MD
Enumeration date
06/10/2006
Last updated
05/07/2012
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