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General NPI Number Information
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NPI Number | 1851323000
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Entity Type | Individual
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Provider Name | ROBERT CARL BRUTKIEWICZ MD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 6345 AIRPORT BLVD STE S
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City | MOBILE
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State | AL
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Zip | 36608-3127
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Country | US
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Telephone | 251-344-1515
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Fax | 251-344-1455
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Provider Business Mailing Address
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Address Line | PO BOX 850489
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City | MOBILE
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State | AL
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Zip | 36685-0489
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Country | US
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Telephone | 251-342-3949
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Fax | 251-631-3361
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 15937
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License Number State | AL
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