NPI 1114160215 · live from the CMS NPI Registry
Michael Ryan Brunson, M.D.
Pediatrics, Adolescent Medicine in Apo, AP. National Provider Identifier 1114160215, active.
NPI record
| NPI | 1114160215 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics, Adolescent Medicine 2080A0000X |
| Practice location | 35th Mdg, Unit 5024, Apo, AP 96319 |
| Practice phone | 315-226-6495 |
| Mailing address | 4102 Pinion Drive, 10th Medical Group, Usaf Academy, CO 80840 |
| Enumerated | April 20, 2009 |
| Last updated | June 30, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Pediatrics | 208000000X | 26095 (NE) |
| Pediatrics, Adolescent Medicine primary | 2080A0000X | 26095 (NE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.