Provider Demographics
NPI:1609033422
Name:STEPHEN R. BRENNAN, D.O., P.A.
Entity Type:Organization
Organization Name:STEPHEN R. BRENNAN, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-363-5437
Mailing Address - Street 1:109 WOODBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1450
Mailing Address - Country:US
Mailing Address - Phone:207-363-5437
Mailing Address - Fax:207-351-1722
Practice Address - Street 1:109 WOODBRIDGE RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1450
Practice Address - Country:US
Practice Address - Phone:207-363-5437
Practice Address - Fax:207-351-1722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty