Healthcare Provider Details

I. General information

NPI: 1538133889
Provider Name (Legal Business Name): BARRY ALAN BRUGGERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 06/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 NEW WAVERLY PLACE CARY OB GYN
CARY NC
27511
US

IV. Provider business mailing address

550 NEW WAVERLY PLACE
CARY NC
27511
US

V. Phone/Fax

Practice location:
  • Phone: 919-467-5941
  • Fax: 919-655-0532
Mailing address:
  • Phone: 919-467-5941
  • Fax: 919-655-0532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number25233
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: