Individual
RICHARD V. BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13135 LEE JACKSON MEMORIAL HWY STE 305, FAIRFAX, VA 22033-1907
(703) 359-8640
(703) 591-6105
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5699
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101049354
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058273300
—
DC
05
—
613002000
—
MD
05
—
7300026
—
VA
Enumeration date
09/23/2005
Last updated
10/31/2021
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