Individual
BRIAN MICHAEL PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 384-6800
(937) 384-6896
Mailing address
3131 NEWMARK DR STE 220, MIAMISBURG, OH 45342-5400
(937) 436-4658
(937) 436-4984
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.126888
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150453
—
OH
Enumeration date
07/12/2010
Last updated
05/06/2020
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