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General NPI Number Information
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NPI Number | 1922054758
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Entity Type | Individual
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Provider Name | JOHN W. BRENEMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 405 PHOENIX DR UNIT A
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-4534
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Country | US
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Telephone | 717-263-4999
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Fax | 717-263-5522
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Provider Business Mailing Address
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Address Line | PO BOX 584
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City | SHIPPENSBURG
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State | PA
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Zip | 17257-0584
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Country | US
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Telephone | 717-263-4999
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Fax | 717-263-5522
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD010487E
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License Number State | PA
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