# DOUGLAS J. BRUNNER, M. D.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891836276
- **Authorized official:** DR. DOUGLAS J. BRUNNER MD (MD)
- **Authorized official phone:** (610) 595-6521

## Contact information

- **Practice address:** 175 E CHESTER PIKE, RIDLEY PARK, PA 19078-2212
- **Practice address phone:** (610) 595-6542
- **Practice address fax:** (610) 595-6077
- **Mailing address:** 175 E CHESTER PIKE, RIDLEY PARK, PA 19078-2212
- **Mailing address phone:** (610) 595-6521
- **Mailing address fax:** (610) 595-6077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | MD027564E | PA | Yes |

## Other

- **Enumeration date:** 02/09/2007
- **Last updated:** 10/15/2007