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General NPI Number Information
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NPI Number | 1356344626
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Entity Type | Individual
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Provider Name | BRIAN B BRUGGEMAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 14155 N. 83RD AVE SUITE 147
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City | PEORIA
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State | AZ
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Zip | 85381
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Country | US
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Telephone | 623-230-2200
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Fax | 208-535-4564
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Provider Business Mailing Address
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Address Line | 14155 N. 83RD AVE SUITE 147
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City | PEORIA
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State | AZ
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Zip | 85381
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Country | US
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Telephone | 602-230-2200
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Fax | 208-535-4564
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | M10264
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 83551
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 101550
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 22884
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License Number State | NH
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Taxonomy #5
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 31346
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License Number State | AZ
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