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Individual

ROBERT GREVILLE BRUMMETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
855 TUCK ST, SUITE 1, LEBANON, PA 17042-7478
(717) 273-5395
Mailing address
855 TUCK ST STE 1, LEBANON, PA 17042-7214
(717) 273-5395

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD422572
PA
208M00000X
Hospitalist Physician
Primary
MD422572
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100983589
PA
01
1628596
HIGHMARK BLUE SHIELD
PA
01
243866
HEALTHAM/HEALTH ASSURANCE
PA
Enumeration date
07/06/2006
Last updated
09/12/2024
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