Individual
DR. SEAN T BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3909 NEW VISION DR, FORT WAYNE, IN 46845-1725
(260) 469-6602
(260) 969-3065
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01042760A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000595566
ANTHEM
IN
05
—
200018650
—
IN
Enumeration date
08/20/2006
Last updated
10/10/2022
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