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Individual

DR. MICHELE E BRENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2001 MEDICAL PKWY, ANNAPOLIS, MD 21401-3280
(443) 481-1000
(443) 481-6588
Mailing address
PO BOX 64262, BALTIMORE, MD 21264-4262
(443) 481-6481
(443) 481-6515

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
D0056708
MD
208000000X
Pediatrics Physician
Primary
D0056708
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0006
CAREFIRST
01
10752
JHHC
01
226883
KAISER
01
60890501
BCBS
MD
01
60890501
CAREFIRST
05
973701400
MD
01
Y1220002
BCBS
DC
Enumeration date
10/10/2005
Last updated
08/01/2011
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