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General NPI Number Information
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NPI Number | 1407119266
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Entity Type | Individual
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Provider Name | MATTHEW BRUEHL MD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 160 E ERIE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1011
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Country | US
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Telephone | 215-427-4067
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Fax |
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Provider Business Mailing Address
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Address Line | 224 E HOLDING AVE # 1557
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City | WAKE FOREST
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State | NC
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Zip | 27587-2903
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Country | US
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Telephone | 984-308-1725
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Fax |
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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 | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 2015-00802
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 35.152967
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 336628
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | MD488449
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License Number State | PA
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