Healthcare Provider Details

I. General information

NPI: 1750086203
Provider Name (Legal Business Name): BRENNAN CULL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8655 MARKET ST
MENTOR OH
44060-4112
US

IV. Provider business mailing address

8655 MARKET ST
MENTOR OH
44060-4112
US

V. Phone/Fax

Practice location:
  • Phone: 440-699-5915
  • Fax:
Mailing address:
  • Phone: 440-699-5915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1750086203
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: