Individual
MR. DAVID LAWRENCE BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C, MS
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 815-5830
(910) 815-5698
Mailing address
PO BOX 602484, CHARLOTTE, NC 28260-2484
(910) 815-5830
(910) 815-5698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02442
NC
363AM0700X
Medical Physician Assistant
008246
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790878304
—
NC
05
—
8102441
—
NC
Enumeration date
10/02/2006
Last updated
06/26/2014
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