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General NPI Number Information
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NPI Number | 1326087024
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Entity Type | Individual
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Provider Name | ROBERT ALEXIS BRENNAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 13023 TESSON FERRY RD SUITE 103
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City | SAINT LOUIS
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State | MO
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Zip | 63128-3480
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Country | US
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Telephone | 314-849-3711
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Fax | 314-849-0235
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Provider Business Mailing Address
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Address Line | 13023 TESSON FERRY RD SUITE 103
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City | SAINT LOUIS
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State | MO
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Zip | 63128-3480
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Country | US
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Telephone | 314-849-3711
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Fax | 314-849-0235
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MDR7047
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 336-068943
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License Number State | IL
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