Provider Demographics
NPI:1043268584
Name:BRENDER, WILLIAM CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHARLES
Last Name:BRENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 SANFORD ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-2427
Mailing Address - Country:US
Mailing Address - Phone:518-338-3322
Mailing Address - Fax:518-542-9143
Practice Address - Street 1:245 SANFORD ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-2427
Practice Address - Country:US
Practice Address - Phone:518-338-3322
Practice Address - Fax:518-542-9143
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149722-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
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