MEDICARE: PETER BRUNO M.D.P.C.

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
1	261QM2500X	Medical Specialty Clinic/Center	044418	MI

General Provider Information

NPI Number	:	1386951176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETER BRUNO M.D.P.C.

Provider Business Mailing Address
First Line	:	245 E WARWICK DR
Second Line	:
City	:	ALMA
State	:	MI
Zip	:	48801-1026
Country	:	US
Telephone Number	:	989-463-5928
Fax Number	:	989-463-5967

Provider Business Practice Location Address
First Line	:	245 E WARWICK DR
Second Line	:
City	:	ALMA
State	:	MI
Zip	:	48801-1026
Country	:	US
Telephone Number	:	989-463-5928
Fax Number	:	989-463-5967

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PETER BRUNO
Credential	:	M.D.
Telephone Number	:	989-463-5928

Provider Enumeration Date	:	09/01/2010
Last Update Date	:	09/01/2010

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