Provider Demographics
NPI:1366418667
Name:BRENNAN, TERRENCE PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:PATRICK
Last Name:BRENNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27472 SCHOENHERR RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6675
Mailing Address - Country:US
Mailing Address - Phone:586-751-8844
Mailing Address - Fax:586-751-8596
Practice Address - Street 1:27472 SCHOENHERR RD STE 100
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6675
Practice Address - Country:US
Practice Address - Phone:586-751-8844
Practice Address - Fax:586-751-8596
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301037453207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2724805Medicaid
MIA78037Medicare UPIN
MIN8184002Medicare PIN
MI2724805Medicaid