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Individual
MR. WILLIAM BRUNDIDGE JR.
Active
Individual
MR. WILLIAM BRUNDIDGE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125070650
IL
208000000X
Pediatrics Physician
125070650
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
04/20/2017
Last updated
08/13/2017
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