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NPI Code Detail

MEDICARE: DR. MICHAEL JOSEPH BRENNER PHARM.D.

MEDICARE: DR. MICHAEL JOSEPH BRENNER PHARM.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
1183500000XPharmacistPS38957FL
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist5302039147MI
31835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPS38957FL

General Provider Information

NPI Number : 1679562581
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JOSEPH BRENNER PHARM.D.
Provider Business Mailing Address
First Line : 6151 RAINTREE DR
Second Line :
City : CANTON
State : MI
Zip : 48187-3633
Country : US
Telephone Number : 617-290-2721
Fax Number :
Provider Business Practice Location Address
First Line : 2215 FULLER RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2303
Country : US
Telephone Number : 734-769-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2005
Last Update Date : 04/10/2012

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