Individual
DONALD J BRUNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 N THEATRE RD, MARION, IN 46952-1700
(765) 662-4142
Mailing address
830 NORTH BALDWIN AVE, MARION, IN 46952-2612
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01026204A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082189
BC BS
IN
01
—
000000193001
BC BS
IN
05
—
200006380A
—
IN
01
—
300064851
RAILROAD MEDICARE
IN
01
—
300127024
RAILROAD MEDICARE
IN
Enumeration date
07/19/2005
Last updated
09/05/2012
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