Individual
MICHELLE G. BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7179
(757) 668-7835
Mailing address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7179
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101054465
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010268141
—
VA
Enumeration date
07/11/2006
Last updated
02/14/2013
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