Provider Demographics
NPI:1760667737
Name:BRENYO, ANDREW JAMES (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JAMES
Last Name:BRENYO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 CARDIOLOGY DR STE 212
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1174
Mailing Address - Country:US
Mailing Address - Phone:803-324-5135
Mailing Address - Fax:803-324-8161
Practice Address - Street 1:196 CARDIOLOGY DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1174
Practice Address - Country:US
Practice Address - Phone:803-324-5135
Practice Address - Fax:803-324-8161
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253893-1207R00000X
SC35466207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC354663Medicaid
SC354663Medicaid