Brenneman, Randall James

Brenneman, Randall James is an individual health care provider with primary practice located at 4921 Parkview Pl Dept Radiation Oncology, Ll, Saint Louis MO 63110-1032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Brenneman, Randall James can be contacted via phone (314) 747-7236.

Contact Information

Primary practice address
4921 Parkview Pl Dept Radiation Oncology, Ll Saint Louis MO 63110-1032
Phone: (314) 747-7236
Fax: (314) 747-9557
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 2021019467 Missouri

Profile Details

NPI number 1366899841
LBN Legal business name Brenneman, Randall James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2016
Last updated Dec 15th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366899841 NPPES
Missouri MEDICAID 200061655

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