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Individual

PETER A. BRENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1350 CLEVELAND ST, GREENVILLE, SC 29607-2408
(864) 271-1450
Mailing address
7 INDEPENDENCE PT, SUITE 140, GREENVILLE, SC 29615-4566
(864) 797-6044

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
7125
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
071255
SC
01
4556601
AETNA
SC
01
57-1004971003
BCBS OF SC
SC
Enumeration date
06/06/2006
Last updated
01/31/2008
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