Individual
DR. MARIELLE ALYSSA BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 353-6360
(319) 353-7006
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 353-6360
(319) 353-7006
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01083722A
IN
207P00000X
Emergency Medicine Physician
7025520
WI
207P00000X
Emergency Medicine Physician
Primary
MD-49363
IA
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
MD-49363
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300037013
—
IN
Enumeration date
04/02/2017
Last updated
08/19/2022
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