MEDICARE: PETER J 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
1	208600000X	Surgery Physician	044418	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0290041	OTHER		BCBSM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740261635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER J BRUNO MD

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	07/08/2007

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Directions to “ PETER J BRUNO MD” Practice Location

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