MEDICARE: DEBORA SANTOS BRUNO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	23664	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	249581	OTHER	NE	MIDLANDS CHOICE
2	30418	OTHER	NE	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437100302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORA SANTOS BRUNO M.D.

Provider Business Mailing Address
First Line	:	702 W 35TH ST
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-7385
Country	:	US
Telephone Number	:	402-460-5899
Fax Number	:	402-460-5619

Provider Business Practice Location Address
First Line	:	815 N KANSAS AVE
Second Line	:	SUITE 100
City	:	HASTINGS
State	:	NE
Zip	:	68901-4470
Country	:	US
Telephone Number	:	402-460-5899
Fax Number	:	402-460-5619

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	09/17/2008

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