Individual
NICHOLAS R BRENING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 N 1900 E RM 4C116, SALT LAKE CITY, UT 84132-0002
(308) 631-1997
Mailing address
30 N 1900 E RM 4C116, SALT LAKE CITY, UT 84132-0002
(308) 631-1997
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
10097486-1205
UT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
10097486-1205
UT
Other
Enumeration date
03/30/2015
Last updated
10/28/2021
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