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General NPI Number Information
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NPI Number | 1003812660
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Entity Type | Individual
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Provider Name | EDMUND J BRENNAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 1101 26TH ST S
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City | GREAT FALLS
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State | MT
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Zip | 59405-5161
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Country | US
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Telephone | 406-731-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 26TH ST S
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City | GREAT FALLS
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State | MT
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Zip | 59405-5161
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Country | US
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Telephone | 406-731-8888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 28201
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 28201
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 65654
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License Number State | MT
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