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General NPI Number Information
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NPI Number | 1578535563
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Entity Type | Individual
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Provider Name | BRUCE HOWARD BRENNAMAN MD
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 920 18TH ST
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City | COLUMBUS
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State | GA
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Zip | 31901-1524
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Country | US
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Telephone | 706-649-6600
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Fax | 706-649-6614
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Provider Business Mailing Address
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Address Line | PO BOX 1038
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City | COLUMBUS
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State | GA
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Zip | 31902-1038
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Country | US
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Telephone | 706-660-6148
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Fax | 706-660-2843
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 31709
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 31709
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License Number State | GA
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