Provider Demographics
NPI:1174519730
Name:BRENNAN, BEVERLY A (MD)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:A
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:600 PRIMROSE ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-2659
Mailing Address - Country:US
Mailing Address - Phone:978-469-7100
Mailing Address - Fax:978-469-7199
Practice Address - Street 1:600 PRIMROSE ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-469-7100
Practice Address - Fax:978-469-7199
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2019-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA206547207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1174519730OtherAETNA HMO
0029557OtherNEIGHBORHOOD HEALTH PLAN
MA1174519730OtherFALLON COMMUNITY HEALTH PLAN
P00258103OtherRAILROAD MEDICARE
04-09138OtherEVERCARE
NHG43721OtherANTHEM BLUE CROSS
MA690835OtherHARVARD PILGRIM HEALTH PL
MA5731408OtherAETNA NON HMO
683113OtherHEALTHSOURCE
MAJ29478OtherBLUE CROSS BLUE SHIELD
206547OtherTUFTS HEALTH PLAN
NV30205508OtherNEW HAMPSHIRE MEDICAID
967080OtherNETWORK HEALTH
MA110041739AMedicaid
7241783OtherCIGNA
683113OtherHEALTHSOURCE
MA110041739AMedicaid