Healthcare Provider Details

I. General information

NPI: 1669471074
Provider Name (Legal Business Name): MICHAEL ROBERT BRUMUND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EMORY UNIVERSITY HOSPITAL AND CLINICS 1364 CLIFTON ROAD
ATLANTA GA
30322-0001
US

IV. Provider business mailing address

14025 HENCH LN
ORLANDO FL
32827-7466
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-2000
  • Fax:
Mailing address:
  • Phone: 225-614-3143
  • Fax: 225-614-3143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number13782R
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RA0002X
TaxonomyAdult Congenital Heart Disease Physician
License Number42022
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: