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NPI Code Detail

MEDICARE: MR. CRAIG GEORGE BRUNO PA

MEDICARE: MR. CRAIG GEORGE BRUNO PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant100083NC

General Provider Information

NPI Number : 1225017858
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CRAIG GEORGE BRUNO PA
Provider Business Mailing Address
First Line : 101 CHRISTINA DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-8125
Country : US
Telephone Number : 252-756-5545
Fax Number : 252-756-5545
Provider Business Practice Location Address
First Line : 3121 MOSELEY DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-4245
Country : US
Telephone Number : 252-758-4455
Fax Number : 252-758-6742
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2006
Last Update Date : 07/08/2007

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Directions to “ MR. CRAIG GEORGE BRUNO PA” Practice Location

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