Provider Demographics
NPI:1295796225
Name:GERMANY, BRETT A (MD)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:A
Last Name:GERMANY
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 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4730 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3570
Practice Address - Country:US
Practice Address - Phone:952-853-8800
Practice Address - Fax:612-313-0004
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN54815207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100103170AMedicaid
OK100103170AMedicaid
OK930126931Medicare PIN
OK930107855Medicare PIN
OKP00462137Medicare PIN
OKH40391Medicare UPIN
OK247226118Medicare PIN
OK24H618602Medicare PIN
OK245520702Medicare PIN