Individual
DR. MICHAEL W BRUEGGEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 WEST FOREST, STE 200, JACKSON, TN 38301
(731) 541-9490
(731) 541-9485
Mailing address
700 WEST FOREST, STE 200, JACKSON, TN 38301
(731) 541-9490
(731) 541-9485
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
13742
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0050209
BCBST
TN
01
—
0702090003
PALMETTO GBA DME
TN
01
—
130006552
RAILROAD MEDICARE
TN
05
—
3008329
—
TN
01
—
38955
MEMPHIS MANAGED CARE
TN
01
—
4182440
BCBS
TN
Enumeration date
09/14/2006
Last updated
07/03/2013
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