Healthcare Provider Details

I. General information

NPI: 1013908276
Provider Name (Legal Business Name): GEORGE BREN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 M ST NW SUITE 804
WASHINGTON DC
20037-1404
US

IV. Provider business mailing address

2440 M ST NW SUITE 804
WASHINGTON DC
20037-1404
US

V. Phone/Fax

Practice location:
  • Phone: 202-785-4966
  • Fax: 202-728-0905
Mailing address:
  • Phone: 202-785-4966
  • Fax: 202-728-0905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD12915
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0042707
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: