Individual
DR. JEANNINE MARIE BREVIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12351 PERRY HWY, WEXFORD, PA 15090-8344
(724) 939-3673
Mailing address
12351 PERRY HWY, WEXFORD, PA 15090-8344
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD459364
PA
208M00000X
Hospitalist Physician
MD459364
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103243829
—
PA
01
—
13963611
CAQH
PA
Enumeration date
06/15/2013
Last updated
11/30/2023
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