DR. BRUCE MERRTILL TENNEBAUM M.D. NPI 1801089024

NPI Information

NPI: 1801089024
Provider Name: DR. BRUCE MERRTILL TENNEBAUM, M.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

Address:
3812 ZENITH AVE S
MINNEAPOLIS, MN
ZIP 55410
Phone: (612) 929-8087
Get Directions

DR. Bruce Merrtill Tennebaum, M.D. is a neurology psychiatry neurology in Minneapolis, MN. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. DR. Bruce Merrtill Tennebaum, M.D. NPI is 1801089024. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3812 ZENITH AVE S
MINNEAPOLIS, MN
ZIP 55410-167
Phone: (612) 929-8087

The enumeration date for this NPI number is 8/21/2007 and was last updated on 8/21/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	20151	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A94246	MEDICARE PIN	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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