Individual
NATHAN BRUNKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301110876
MI
207P00000X
Emergency Medicine Physician
Primary
65126
MN
390200000X
Student in an Organized Health Care Education/Training Program
4301110876
MI
Other
Enumeration date
07/07/2016
Last updated
05/07/2019
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