MEDICARE: STEVEN BRUNER M.D.

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	207Q00000X	Family Medicine Physician	0415429	KS

Other Identifiers

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

General Provider Information

NPI Number	:	1962405324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN BRUNER M.D.

Provider Business Mailing Address
First Line	:	1200 SCHWEGLER DR
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66045-7558
Country	:	US
Telephone Number	:	785-864-9525
Fax Number	:	785-864-9596

Provider Business Practice Location Address
First Line	:	1200 SCHWEGLER DR
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66045-7558
Country	:	US
Telephone Number	:	785-964-9525
Fax Number	:	785-864-9596

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	12/16/2015

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