MEDICARE: DR. MICHAEL ROBERT BRUMUND 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	2080P0202X	Pediatric Cardiology Physician	13782R	LA
2	207RA0002X	Adult Congenital Heart Disease Physician	42022	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669471074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ROBERT BRUMUND M.D.

Provider Business Mailing Address
First Line	:	14025 HENCH LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7466
Country	:	US
Telephone Number	:	225-614-3143
Fax Number	:	225-614-3143

Provider Business Practice Location Address
First Line	:	EMORY UNIVERSITY HOSPITAL AND CLINICS 1364 CLIFTON ROAD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-0001
Country	:	US
Telephone Number	:	404-712-2000
Fax Number	:

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	06/16/2025

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