Individual
MICHAEL PHILIP BRONNENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
250 PLEASANT ST, CONCORD, NH 03301-7539
(603) 227-7000
Mailing address
53 MAIN ST, CHICHESTER, NH 03258-6509
(603) 897-9128
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PENDING
NH
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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