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NPI Code Detail

MEDICARE: DR. KAREN BRENNER M.D.

MEDICARE: DR. KAREN 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
1208000000XPediatrics Physician4301070174MI

General Provider Information

NPI Number : 1851368591
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAREN BRENNER M.D.
Provider Business Mailing Address
First Line : 24 FRANK LLOYD WRIGHT DR
Second Line : PO BOX 0446
City : ANN ARBOR
State : MI
Zip : 48105-9484
Country : US
Telephone Number : 734-747-6766
Fax Number : 734-222-3100
Provider Business Practice Location Address
First Line : 4936 W CLARK RD
Second Line : SUITE 101
City : YPSILANTI
State : MI
Zip : 48197-0861
Country : US
Telephone Number : 734-434-3000
Fax Number : 734-434-8040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 01/12/2017

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