Provider Demographics
NPI:1346411246
Name:ROBERT T BRENGEL DO & OLAN C DOMBROSKE DO, PTRS
Entity Type:Organization
Organization Name:ROBERT T BRENGEL DO & OLAN C DOMBROSKE DO, PTRS
Other - Org Name:BROWN CITY HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:BRENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-346-2757
Mailing Address - Street 1:7115 CADE RD
Mailing Address - Street 2:
Mailing Address - City:BROWN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48416-9778
Mailing Address - Country:US
Mailing Address - Phone:810-346-2757
Mailing Address - Fax:810-346-2016
Practice Address - Street 1:7115 CADE RD
Practice Address - Street 2:
Practice Address - City:BROWN CITY
Practice Address - State:MI
Practice Address - Zip Code:48416-9778
Practice Address - Country:US
Practice Address - Phone:810-346-2757
Practice Address - Fax:810-346-2016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty