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General NPI Number Information
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NPI Number | 1578973087
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Entity Type | Individual
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Provider Name | JAMES BRUNO DO
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Gender | Male
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 2961 SAINT ANTHONY DR
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City | GREEN BAY
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State | WI
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Zip | 54311-5860
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Country | US
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Telephone | 920-468-0861
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Fax |
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Provider Business Mailing Address
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Address Line | 1326 WESTWOOD DR
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City | NEENAH
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State | WI
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Zip | 54956-1334
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Country | US
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Telephone | 920-637-4665
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 67621
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License Number State | WI
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