Provider Demographics
NPI:1891290144
Name:SONGER, BREANN M
Entity Type:Individual
Prefix:
First Name:BREANN
Middle Name:M
Last Name:SONGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40823 MIDLAND TRL E
Mailing Address - Street 2:
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-5064
Mailing Address - Country:US
Mailing Address - Phone:304-536-4870
Mailing Address - Fax:
Practice Address - Street 1:40823 MIDLAND TRL E
Practice Address - Street 2:
Practice Address - City:WHITE SULPHUR SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:24986-5064
Practice Address - Country:US
Practice Address - Phone:304-536-4870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3710207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine