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NPI Code Detail

MEDICARE: PATRICK BRUNO MD

MEDICARE: PATRICK BRUNO MD
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
1207V00000XObstetrics & Gynecology Physician35.096568OH
2207RA0401XAddiction Medicine (Internal Medicine) Physician35096568OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639170509
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK BRUNO MD
Provider Business Mailing Address
First Line : 3535 LEE RD
Second Line :
City : SHAKER HEIGHTS
State : OH
Zip : 44120-5122
Country : US
Telephone Number : 216-417-6166
Fax Number : 216-417-8676
Provider Business Practice Location Address
First Line : 4265 S A ST
Second Line :
City : RICHMOND
State : IN
Zip : 47374-6049
Country : US
Telephone Number : 765-962-8843
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 06/24/2025

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