Brenner, Mark

Brenner, Mark is an individual health care provider with primary practice located at 2946 E Banner Gateway Drive , Gilbert AZ 85234. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Brenner, Mark can be contacted via phone (480) 256-6444.

Contact Information

Primary practice address
2946 E Banner Gateway Drive Gilbert AZ 85234
Phone: (480) 256-6444
Fax: (480) 256-4734
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 2207 Arizona

Profile Details

NPI number 1750390456
LBN Legal business name Brenner, Mark
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated May 18th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750390456 NPPES
Arizona MEDICAID 258914
Arizona Other 4316747
Arizona Other AZ0063470
Arizona Other 1Z0539

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