Individual
TERRY RICHARD BRENNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5816 CREEDMOOR RD, SUITE 104, RALEIGH, NC 27612-2310
(919) 787-9555
(919) 510-5111
Mailing address
5816 CREEDMOOR RD, SUITE 104, RALEIGH, NC 27612-2310
(919) 787-9555
(919) 510-5111
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27129
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18164
BLUE CROSS
NC
Enumeration date
12/19/2007
Last updated
12/19/2007
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