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Individual

DR. ELAINE M BRENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2300 HAGGERTY RD, 2150, WEST BLOOMFIELD, MI 48323-2184
(248) 926-6610
(248) 926-6611
Mailing address
2300 HAGGERTY RD, 2150, WEST BLOOMFIELD, MI 48323-2184
(248) 926-6610
(248) 926-6611

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301053483
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0F37550
BCBSM
MI
05
104530972
MI
01
383468933
COMMERCIAL INSURANCE CO.
MI
01
F01718
HAP
MI
01
P00055649
RAILROAD MEDICARE
MI
Enumeration date
03/24/2006
Last updated
06/28/2011
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