Individual
RONALD T BRUNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9454 THREE RIVERS RD, SUITE A, GULFPORT, MS 39503-4294
(228) 864-7747
(228) 864-7415
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 864-7747
(228) 864-7415
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
6702
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00014208
—
MS
05
—
0014208
—
MS
05
—
09015616
—
MS
01
—
640935888
TAX IDENTIFICATION NUMBER
MS
Enumeration date
09/07/2006
Last updated
07/10/2014
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