Healthcare Provider Details

I. General information

NPI: 1659463107
Provider Name (Legal Business Name): CHARLES BRUDNEY MB BCH, FRCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DUKE UNIVERSITY HEALTH SYSTEM ERWIN RD
DURHAM NC
27710-0001
US

IV. Provider business mailing address

7 LITCHFORD RD
CHAPEL HILL NC
27514-9243
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-6938
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: