Individual
RICHARD D BRENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 W RIDGE RD, WYTHEVILLE, VA 24382-1044
(276) 228-0200
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101243916
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00694550
RR MEDICARE
VA
Enumeration date
09/26/2005
Last updated
01/24/2014
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