Basic Information
| Provider Information | |||||||||
| NPI: | 1588846422 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHAEL J BRENNAN MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2222 E HIGHLAND AVE STE 425 | ||||||||
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| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6026676640 | ||||||||
| FaxNumber: | 6026673191 | ||||||||
| Practice Location | |||||||||
| Address1: | 2222 E HIGHLAND AVE STE 425 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6026676640 | ||||||||
| FaxNumber: | 6026673191 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2007 | ||||||||
| LastUpdateDate: | 07/27/2010 | ||||||||
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| AuthorizedOfficialLastName: | BRENNAN | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6026676640 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD PC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.