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1790726412

NPI Code Detail

MEDICARE: LUCA BRUNELLI MD

MEDICARE: LUCA BRUNELLI MD

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	208000000X	Pediatrics Physician	29550	NE
2	2080N0001X	Neonatal-Perinatal Medicine Physician	MED-PHYS-LIC-149855	MT
3	2080N0001X	Neonatal-Perinatal Medicine Physician	L8290	TX
4	2080N0001X	Neonatal-Perinatal Medicine Physician	68789661205	UT
5	208000000X	Pediatrics Physician	L8290	TX
6	2080N0001X	Neonatal-Perinatal Medicine Physician	46249	OK

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	8J5408	OTHER	TX	BCBS
3	164227401	OTHER	TX	CSHCN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790726412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCA BRUNELLI MD

Provider Business Mailing Address
First Line	:	915 HIGHLAND BLVD
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59715-6902
Country	:	US
Telephone Number	:	406-414-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 HIGHLAND BLVD
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59715-6902
Country	:	US
Telephone Number	:	406-414-5000
Fax Number	:

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

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	06/04/2026

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Directions to “ LUCA BRUNELLI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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