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NPI Code Detail

MEDICARE: DR. MICHAEL BRENNER M.D.

MEDICARE: DR. MICHAEL BRENNER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician35697IA
2207Q00000XFamily Medicine Physician23232NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114992674
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL BRENNER M.D.
Provider Business Mailing Address
First Line : 200 GOLD CIR STE 120
Second Line :
City : DAKOTA DUNES
State : SD
Zip : 57049-5501
Country : US
Telephone Number : 605-217-0700
Fax Number : 605-217-0701
Provider Business Practice Location Address
First Line : 3250 PLAZA DR
Second Line :
City : SOUTH SIOUX CITY
State : NE
Zip : 68776-3144
Country : US
Telephone Number : 402-412-4220
Fax Number : 402-412-4222
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 02/27/2026

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Directions to “ DR. MICHAEL BRENNER M.D.” Practice Location

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