DR. PATRICK R BRENNAN (NPI# 1770582793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770582793 |
| Entity Type | Individual |
| Full Name | DR. PATRICK R BRENNAN |
| Credential | D.O. |
| Practice Address |
22024 Pontiac Trl South Lyon MI 48178-9410 |
| Practice Telephone | 2484372525 |
| Practice Fax Number | 2484372526 |
| Mailing Telephone | 2484372525 |
| Mailing Fax Number | 2484372526 |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2007-07-08 |
| NPI Deactivation Date | 03/20/2006 |
| NPI Reactivation Date | 2006-03-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | PB5101014989 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | AETNA | 7323572 | 01 |
| MI | CARE CHOICE | 139314 | 01 |
| MI | BLUE CROSS PROVIDER I.D. | 5631170 | 01 |
| MI | PREFERRED CHOICE | 139314 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629508023 | Patrick James Brennan | Pharmacist | 692 Freeman Ln Ste A, Grass Valley, CA 95949-9616 | 2017-06-18 |
| 1801221940 | Patrick D Brennan | Chiropractor | 4616 N Western Ave, Chicago, IL 60625-2023 | 2013-09-09 |
| 1265566152 | Patrick Joseph Brennan | Physical Therapist | 545 Palisado Ave, Windsor, CT 06095-2071 | 2007-03-15 |
| 1104876945 | Patrick James Brennan | Surgery | 100 Theda Clark Medical Plz, Suite 400, Neenah, WI 54956-2763 | 2006-05-11 |
| 1962013037 | Patrick J Brennan | Pharmacist | 329 E Main St, Branford, CT 06405-3106 | 2020-08-12 |
| 1295354264 | Patrick M Brennan | Family Medicine | 3500 W Wheatland Rd, Dallas, TX 75237-3460 | 2020-04-10 |
| 1598307902 | Patrick Brennan | Physical Therapy Assistant | 1120 S Utica Ave, Tulsa, OK 74104-4012 | 2019-10-17 |
| 1407366859 | Patrick B. Brennan | Registered Nurse | 55 Lake Ave N, Worcester, MA 01655-0002 | 2017-10-11 |
| 1972921617 | Patrick Brennan | Physical Medicine & Rehabilitation | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2014-03-31 |
| 1548532369 | Patrick R Brennan | Physical Therapist | 19830 Middlebelt Rd, Livonia, MI 48152-2048 | 2012-02-09 |
| Street Address |
22024 PONTIAC TRL |
| City | SOUTH LYON |
| State | MI |
| Zip Code | 48178-9410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972953974 | Aaron Collins | Nurse Practitioner | 22024 Pontiac Trl, South Lyon, MI 48178-9410 | 2016-06-21 |
| 1518004084 | South Lyon Family Physicians, Pllc | Family Medicine | 22024 Pontiac Trl, South Lyon, MI 48178-9410 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231815 | Bhoomi Shah | Pharmacist | 22318 Pontiac Trail, South Lyon, MI 48178 | 2020-06-27 |
| 1649811845 | Center for Emdr and Trauma Therapy | Counselor | 28900 Pontiac Trail, South Lyon, MI 48178 | 2019-09-30 |
| 1295223386 | Cathrine Michelle Arneson | Massage Therapist | 321 Pettibone St. #101a, South Lyon, MI 48178 | 2018-04-25 |
| 1033592936 | 4-serv Family Medicine P.C. | Family Medicine | 51619 Ten Mile Rd, South Lyon, MI 48178 | 2015-07-09 |
| 1003299777 | James Sullivan | Physical Therapy Assistant | 10821 Bouldercrest Drive, South Lyon, MI 48178 | 2015-06-30 |
| 1255722088 | Jennifer Nidetz | Social Worker | 23015 Cheyenne Dr, South Lyon, MI 48178 | 2015-02-16 |
| 1174938658 | Michael Samir Matar | Family Medicine | 210 N Lafayette Street, South Lyon, MI 48178 | 2014-06-24 |
| 1043633191 | Kwonsoo Kenneth Kim | Anesthesiology | 8854 Stoney Creek Dr., South Lyon, MI 48178 | 2014-01-27 |
| 1285071860 | Ajanthan Sivagurunathan | Student in an Organized Health Care Education/Training Program | 210 North Lafayette, Providence Medical Center - South Lyon, South Lyon, MI 48178 | 2013-05-23 |
| 1184890055 | Yvonne Marie Snyder | Dentist | 100 E Lake St, South Lyon, MI 48178 | 2008-05-01 |
| Find all providers in zip 48178 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033592936 | 4-serv Family Medicine P.C. | Family Medicine | 51619 Ten Mile Rd, South Lyon, MI 48178 | 2015-07-09 |
| 1174938658 | Michael Samir Matar | Family Medicine | 210 N Lafayette Street, South Lyon, MI 48178 | 2014-06-24 |
| 1629200159 | Designed Altobaric Technology Inc | Family Medicine | 21800 Pontiac Trl, South Lyon, MI 48178-9499 | 2009-08-18 |
| 1386889954 | Hpc Health Pllc | Family Medicine | 22990 Pontiac Trl, South Lyon, MI 48178-1641 | 2008-12-10 |
| 1609036409 | Srikar T Reddy | Family Medicine | 51619 10 Mile Rd, South Lyon, MI 48178-9720 | 2008-06-15 |
| 1871705129 | Brandy Eberhardt | Family Medicine | 26006 Pontiac Trl, South Lyon, MI 48178-8050 | 2007-05-07 |
| 1386612406 | Mark Zawisa | Family Medicine | 23200 Pontiac Trl Ste 100, South Lyon, MI 48178-1983 | 2006-03-14 |
| 1083614002 | Promita Roychoudhury | Family Medicine | 210 N Lafayette, South Lyon, MI 48178 | 2005-08-01 |
| 1104820463 | Thomas Joseph Anan | Family Medicine | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2005-06-02 |
| 1063949121 | Lauren Elizabeth Carney | Family Medicine | 210 N Lafayette St, South Lyon, MI 48178-2048 | 2017-05-18 |
| Find all providers in SOUTH LYON | ||||
| City | SOUTH LYON |
| Zip Code | 48178 |
Please comment or provide details below to improve the information on DR. PATRICK R BRENNAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.