# AUDREY J BRUELL DERMATOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AUDREY J BRUELL MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245337179
- **Authorized official:** DAVID DURIN (OFFICE MANAGER)
- **Authorized official phone:** (517) 505-0661

## Contact information

- **Practice address:** 37605 PEMBROKE AVE, LIVONIA, MI 48152-1050
- **Practice address phone:** (734) 591-7931
- **Practice address fax:** (734) 464-0335
- **Mailing address:** 37605 PEMBROKE AVE, LIVONIA, MI 48152-1050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | 4301062941 | MI | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/22/2020