Brenner, Mark J

Brenner, Mark J is an individual health care provider with primary practice located at 20 Washington Sq , Worcester MA 01604-4013. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Radiation Oncology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Brenner, Mark J can be contacted via phone (508) 363-6218.

Contact Information

Primary practice address
20 Washington Sq Worcester MA 01604-4013
Phone: (508) 363-6218
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X D0041640 Maryland
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 54099 Massachusetts

Profile Details

NPI number 1902873409
LBN Legal business name Brenner, Mark J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2006
Last updated May 11th, 2017 - 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1902873409 NPPES
Massachusetts MEDICAID 110085074A
Massachusetts Other 920004528
Massachusetts MEDICAID 168741700
Massachusetts Other 920007556

Popular Providers