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NPI Code Detail

MEDICARE: DR. WAYNE L BRENNEMAN M.D.

MEDICARE: DR. WAYNE L BRENNEMAN 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
1207R00000XInternal Medicine Physician4301040651MI

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 : 1346228913
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WAYNE L BRENNEMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 1848
Second Line :
City : MUSKEGON
State : MI
Zip : 49443-1848
Country : US
Telephone Number : 231-672-8753
Fax Number : 231-672-4932
Provider Business Practice Location Address
First Line : 1500 E SHERMAN BLVD
Second Line :
City : MUSKEGON
State : MI
Zip : 49444-1849
Country : US
Telephone Number : 231-727-5211
Fax Number : 231-727-4571
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2006
Last Update Date : 06/24/2021

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