Healthcare Provider Details

I. General information

NPI: 1922627538
Provider Name (Legal Business Name): BRENNAN MORRISON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BRICKSTONE SQ STE 201
ANDOVER MA
01810-1497
US

IV. Provider business mailing address

60 LONGWOOD AVE APT 209
BROOKLINE MA
02446-5229
US

V. Phone/Fax

Practice location:
  • Phone: 610-892-8889
  • Fax:
Mailing address:
  • Phone: 913-620-0675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1023047
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: