Individual
GREGG BRENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30200 TELEGRAPH RD, SUITE 220, BINGHAM FARMS, MI 48025-4502
(248) 258-5058
Mailing address
3790 LAKECREST DR, BLOOMFIELD, MI 48304-3039
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301061504
MI
Other
Enumeration date
04/24/2006
Last updated
11/07/2007
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