Individual
DR. JERRY JOSEPH BRUGGEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
910 N COLLEGE AVE STE 4, COLUMBIA, MO 65201-4797
(636) 642-1215
(573) 234-4799
Mailing address
910 N COLLEGE AVE STE 4, COLUMBIA, MO 65201-4797
(636) 642-1215
(573) 234-4799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2004011867
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207251901
—
MO
Enumeration date
05/17/2006
Last updated
12/20/2023
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