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NPI Code Detail

MEDICARE: DR. DELON F.P. BRENNEN M.D.

MEDICARE: DR. DELON F.P. BRENNEN 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
12080P0204XPediatric Emergency Medicine (Pediatrics) Physician061826GA
2208000000XPediatrics Physician061826GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982653093
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DELON F.P. BRENNEN M.D.
Provider Business Mailing Address
First Line : 720 WESTVIEW DR SW
Second Line : DEPARTMENT OF PEDIATRICS
City : ATLANTA
State : GA
Zip : 30310-1458
Country : US
Telephone Number : 404-756-1330
Fax Number :
Provider Business Practice Location Address
First Line : 720 WESTVIEW DR SW
Second Line : DEPARTMENT OF PEDIATRICS
City : ATLANTA
State : GA
Zip : 30310-1458
Country : US
Telephone Number : 404-756-1330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 05/07/2009

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