Provider Demographics
NPI:1336726017
Name:BRETON, JEFFREY MICHAEL
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:BRETON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 RESERVOIR ROAD NW, 7PHC
Mailing Address - Street 2:DEPT OF NEUROSURGERY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007
Mailing Address - Country:US
Mailing Address - Phone:202-444-4972
Mailing Address - Fax:202-444-7333
Practice Address - Street 1:3800 RESERVOIR ROAD NW, 7PHC
Practice Address - Street 2:DEPT OF NEUROSURGERY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007
Practice Address - Country:US
Practice Address - Phone:202-444-4972
Practice Address - Fax:202-444-7333
Is Sole Proprietor?:No
Enumeration Date:2021-03-27
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program