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General NPI Number Information
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NPI Number | 1669652814
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Entity Type | Organization
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Legal Business Name | BRUNDIGE FAMILY PRACTICE, P.C.
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 8015 W ALAMEDA AVE SUITE 050
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City | LAKEWOOD
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State | CO
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Zip | 80226-3041
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Country | US
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Telephone | 303-237-0086
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Fax | 303-237-6112
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Provider Business Mailing Address
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Address Line | 8015 W ALAMEDA AVE SUITE 050
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City | LAKEWOOD
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State | CO
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Zip | 80226-3041
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Country | US
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Telephone | 303-237-0086
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Fax | 303-237-6112
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Authorized Official
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Title or Position | MEDICAL
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Name | MS. BARBARA QUIST
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Credential | M.A.
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Telephone | 303-237-0086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 19240
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License Number State | CO
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