Individual
DR. MATHIJS HENRI BRENTJENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 VIRGINIA RD, EDENTON, NC 27932-9667
(252) 752-4124
(252) 758-8954
Mailing address
420 SPRING FOREST RD, GREENVILLE, NC 27834-7244
(252) 752-4124
(252) 758-8954
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
200500012
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140T2
BLUE CROSS BLUE SHIELD NC
NC
05
—
5902501
—
NC
01
—
8899677
CIGNA HEALTLHCARE NC
NC
01
—
P00234813
RAILROAD MEDICARE
NC
Enumeration date
08/07/2006
Last updated
04/07/2009
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