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NPI Code Detail

MEDICARE: DR. STEVEN ROBERT BRENNER M.D.

MEDICARE: DR. STEVEN ROBERT BRENNER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology PhysicianR7224MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083664601
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN ROBERT BRENNER M.D.
Provider Business Mailing Address
First Line : 1438 SOUTH GRAND BOULEVARD
Second Line : DEPT. NEUROLOGY AND PSYCHIATRY, ST. LOUIS UNIVERSITY
City : SAINT LOUIS
State : MO
Zip : 63104-1027
Country : US
Telephone Number : 314-977-6082
Fax Number : 314-977-6086
Provider Business Practice Location Address
First Line : 1438 S GRAND BLVD
Second Line : ST. LOUIS UNIVERSITY, DEPT. NEUROLOGY & PSYCHIATRY
City : SAINT LOUIS
State : MO
Zip : 63104-1027
Country : US
Telephone Number : 314-977-6082
Fax Number : 314-977-6086
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 06/30/2011

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